Physician Compare National (NPI:1891016598)

HEALTHCARE PROVIDER: JESSICA G. KINGSBERG 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	1891016598
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1557591344
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20161130002066
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KINGSBERG
	Individual professional last name
Provider First Name	JESSICA
	Individual professional first name
Provider Middle Name	GORDON
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	TOLEDO MEDICAL COLLEGE
	Individual professional's medical school
Graduation Year	2010
	Individual professional's medical school graduation year
Primary Specialty	ORTHOPEDIC SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	BONE AND JOINT SPECIALISTS
	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	6709863236
	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	8
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2020 PALOMINO LN
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 220
	Group Practice or individual's line 2 address
City	LAS VEGAS
	Group Practice or individual's city
State	NV
	Group Practice or individual's state
Zip Code	891064891
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7024747200
	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	290039
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MOUNTAINVIEW HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	290003
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SUNRISE HOSPITAL AND MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	290054
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	CENTENNIAL HILLS HOSPITAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y