Physician Compare National (NPI:1952879280)

HEALTHCARE PROVIDER: ROMULO MANUEL BANAAG JR.

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

Individual Professional Information
NPI	1952879280
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4789928557
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20181205000989
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BANAAG
	Individual professional last name
Provider First Name	ROMULO
	Individual professional first name
Provider Middle Name	MANUEL
	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	OTHER
	Individual professional's medical school
Graduation Year	2018
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	CITYWIDE HOUSECALLS, LLC
	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	2961626569
	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	4
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1919 S SHILOH RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 218
	Group Practice or individual's line 2 address
City	GARLAND
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	750428903
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9728087541
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y