Physician Compare National (NPI:1942403084)

HEALTHCARE PROVIDER: JUAN CARLOS ORTIZ SANTIAGO 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	1942403084
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9638266737
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20071107000097
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ORTIZ SANTIAGO
	Individual professional last name
Provider First Name	JUAN
	Individual professional first name
Provider Middle Name	C
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY CENTRAL DEL CARIBE ESCUELA DE MEDICINA
	Individual professional's medical school
Graduation Year	2004
	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
Line 1 Street Address	LOS PRADOS MALL
	Group Practice or individual's line 1 address
City	CAGUAS
	Group Practice or individual's city
State	PR
	Group Practice or individual's state
Zip Code	007279507
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7879610091
	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	400120
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HIMA SAN PABLO-CAGUAS
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y