Physician Compare National (NPI:1902911159)

HEALTHCARE PROVIDER: ALFREDO DIAZ 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	1902911159
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6709838113
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050214000901
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DIAZ
	Individual professional last name
Provider First Name	ALFREDO
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1995
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	AURORA MEDICAL GROUP, INC.
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	6709794258
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2554
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1136 WESTOWNE DR
	Group Practice or individual's line 1 address
City	NEENAH
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	549562175
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9204562030
	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	520107
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HOLY FAMILY MEMORIAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	520034
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	AURORA MEDICAL CTR MANITOWOC COUNTY
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y