Physician Compare National (NPI:1902210693)

HEALTHCARE PROVIDER: JONATHAN MATZKIN-BRIDGER DPM

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

Individual Professional Information
NPI	1902210693
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2466753132
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170629002529
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MATZKIN-BRIDGER
	Individual professional last name
Provider First Name	JONATHAN
	Individual professional first 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	2014
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	735 STATE ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 515
	Group Practice or individual's line 2 address
City	SANTA BARBARA
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	931015554
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8056282418
	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	051331
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SANTA YNEZ VALLEY COTTAGE HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y