Physician Compare National (NPI:1891768941)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1891768941
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7416867619
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100601000501
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LOPEZ
	Individual professional last name
Provider First Name	ENRIQUE
	Individual professional first name
Provider Middle Name	C
	Individual professional middle name
Provider Name Suffix Text	III
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3960 PATIENT CARE WAY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 108
	Group Practice or individual's line 2 address
City	LANSING
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	489114276
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5173948589
	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	230230
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	EDWARD W SPARROW HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	230167
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MCLAREN GREATER LANSING
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y