Physician Compare National (NPI:1962786731)

HEALTHCARE PROVIDER: MISTY MOKRYCKI APRN

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

Individual Professional Information
NPI	1962786731
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4981834751
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160627001563
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MOKRYCKI
	Individual professional last name
Provider First Name	MISTY
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2011
	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	WRIGHT STATE PHYSICIANS 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	7618889320
	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	102
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1 WYOMING ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 4130
	Group Practice or individual's line 2 address
City	DAYTON
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	454092722
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9372086810
	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	360051
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MIAMI VALLEY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y