Physician Compare National (NPI:1962400184)

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	1962400184
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2769423938
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050518000354
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TASSIN
	Individual professional last name
Provider First Name	ADAM
	Individual professional first name
Provider Middle Name	JOHN
	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.
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	LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
	Individual professional's medical school
Graduation Year	1969
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1535 W MAIN ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1
	Group Practice or individual's line 2 address
City	VILLE PLATTE
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	705862868
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3373635591
	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	190167
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MERCY REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y