Physician Compare National (NPI:1881689891)

HEALTHCARE PROVIDER: JAMES PATRICK FOGARTY 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	1881689891
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1759270200
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040312000429
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FOGARTY
	Individual professional last name
Provider First Name	JAMES
	Individual professional first name
Provider Middle Name	P
	Individual professional middle name
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	UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1972
	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
Line 1 Street Address	902 W MAIN ST
	Group Practice or individual's line 1 address
City	CAMERON
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	548224910
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	521332
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SPOONER HEALTH SYSTEM
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	240001
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	NORTH MEMORIAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	521336
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HAYWARD AREA MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	521315
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	MAYO CLINIC HEALTH SYSTEM-NORTHLAND
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	520011
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	LAKEVIEW MEDICAL CENTER OF RICE LAKE
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1881689891)

HEALTHCARE PROVIDER: JAMES PATRICK FOGARTY M.D.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information