Physician Compare National (NPI:1891087300)

HEALTHCARE PROVIDER: BARRON JUSTIN REYES 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	1891087300
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6608092549
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20151110002982
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	REYES
	Individual professional last name
Provider First Name	BARRON
	Individual professional first name
Provider Middle Name	JUSTIN
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF VERMONT COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	TETON COUNTY HOSPITAL DISTRICT
	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	4880582295
	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	69
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3345 W CODY LN
	Group Practice or individual's line 1 address
Line 2 Street Address	UNIT 9
	Group Practice or individual's line 2 address
City	TETON VILLAGE
	Group Practice or individual's city
State	WY
	Group Practice or individual's state
Zip Code	830250544
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3077397346
	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	530015
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST JOHNS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	130028
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PORTNEUF MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y