Physician Compare National (NPI:1821080722)

HEALTHCARE PROVIDER: ROBERT F HAVERLY M.D.

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

Individual Professional Information
NPI	1821080722
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6002999703
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120316000736
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HAVERLY
	Individual professional last name
Provider First Name	ROBERT
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1992
	Individual professional's medical school graduation year
Primary Specialty	OPHTHALMOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	LASER EYE SURGERY OF ERIE, 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	1951352244
	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	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	193 E MAIN ST
	Group Practice or individual's line 1 address
City	WESTFIELD
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	147871104
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7163264845
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	390009
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SAINT VINCENT HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330166
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	WESTFIELD MEMORIAL HOSPITAL, INC
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y