Physician Compare National (NPI:1902879299)

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	1902879299
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8426124660
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080911000517
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ELIAS
	Individual professional last name
Provider First Name	GERALD
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Name Suffix Text	JR.
	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	LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	EMERGENCY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	EMERGENCY MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	803 CTR ST
	Group Practice or individual's line 1 address
City	NEW IBERIA
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	705605505
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3373653474
	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	190054
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	IBERIA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	191322
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ABROM KAPLAN MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y