Physician Compare National (NPI:1003847617)

HEALTHCARE PROVIDER: SURINDER MENDIRATTA MD

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

Individual Professional Information
NPI	1003847617
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1254416241
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080315000036
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MENDIRATTA
	Individual professional last name
Provider First Name	SURINDER
	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	1982
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	16001 W 9 MILE RD
	Group Practice or individual's line 1 address
City	SOUTHFIELD
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	480754818
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	230024
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SINAI-GRACE HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	230019
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PROVIDENCE HOSP AND MED CTRS
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	230130
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	BEAUMONT HOSPITAL, ROYAL OAK
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y