Physician Compare National (NPI:1962616383)

HEALTHCARE PROVIDER: BRANDON REYNOLDS M.D.

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

Individual Professional Information
NPI	1962616383
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7517121890
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120618000518
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	REYNOLDS
	Individual professional last name
Provider First Name	BRANDON
	Individual professional first name
Provider Middle Name	Q
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF IOWA, RJ & L CARVER COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	PLASTIC AND RECONSTRUCTIVE SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	HAND SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	HAND SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	REYNOLDS PLASTIC SURGERY
	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	7810151198
	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	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	5550 PAINTED MIRAGE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 217
	Group Practice or individual's line 2 address
City	LAS VEGAS
	Group Practice or individual's city
State	NV
	Group Practice or individual's state
Zip Code	891494620
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7024109800
	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	290046
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SPRING VALLEY HOSPITAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y