Physician Compare National (NPI:1801823729)

HEALTHCARE PROVIDER: LELAND J SOTO III MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1801823729
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8325940992
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050719000256
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SOTO
	Individual professional last name
Provider First Name	LELAND
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Name Suffix Text	III
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	GEISEL SCHOOL OF MEDICINE AT DARTMOUTH
	Individual professional's medical school
Graduation Year	1998
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	GRIFFIN FACULTY PHYSICIANS INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7618871997
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	74
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	350 SEYMOUR AVE
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	DERBY
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	064181336
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	070031
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GRIFFIN HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y