Physician Compare National (NPI:1891861506)

HEALTHCARE PROVIDER: BIENVENIDO T SAMSON 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	1891861506
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2062475924
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090815000126
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SAMSON
	Individual professional last name
Provider First Name	BIENVENIDO
	Individual professional first name
Provider Middle Name	T
	Individual professional middle name
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	1964
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GENERAL SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GENERAL SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	755 E MCMURRY BLVD
	Group Practice or individual's line 1 address
City	HARTSVILLE
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	370742041
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	441301
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TROUSDALE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	440003
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SUMNER REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	441305
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MACON COUNTY GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y