Physician Compare National (NPI:1891998159)

HEALTHCARE PROVIDER: MARIE CLAUDETTE DECASTRO GRAGEDA 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	1891998159
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3577622315
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20081107000340
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GRAGEDA
	Individual professional last name
Provider First Name	MARIE CLAUDETTE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2001
	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	930 SUNNYSLOPE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	C1
	Group Practice or individual's line 2 address
City	HOLLISTER
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	950235617
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8316361751
	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	051337
	Medicare CCN of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y