Physician Compare National (NPI:1003014473)

HEALTHCARE PROVIDER: RAKESH BARAK 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	1003014473
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2365534260
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100923000702
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BARAK
	Individual professional last name
Provider First Name	RAKESH
	Individual professional first name
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	2001
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	WELLSPAN MEDICAL GROUP
	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	1951213115
	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	1119
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	169 MARTIN AVE
	Group Practice or individual's line 1 address
City	EPHRATA
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	175221724
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7177386414
	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	080001
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CHRISTIANA HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	390225
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	WELLSPAN EPHRATA COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	080003
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ST FRANCIS HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	080004
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	BAYHEALTH HOSPITAL, KENT CAMPUS
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y