Physician Compare National (NPI:1851521546)

HEALTHCARE PROVIDER: SHINING SUN 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	1851521546
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8820383102
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160825001332
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SUN
	Individual professional last name
Provider First Name	SHINING
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	CARDIAC ELECTROPHYSIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	COMMUNITY CARE SERVICES LLC
	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	1951324318
	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	325
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	10085 DOUBLE R BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 225
	Group Practice or individual's line 2 address
City	RENO
	Group Practice or individual's city
State	NV
	Group Practice or individual's state
Zip Code	895213855
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7759824035
	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	290001
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	RENOWN REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	290049
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	RENOWN SOUTH MEADOWS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y