Physician Compare National (NPI:1013367416)

HEALTHCARE PROVIDER: SHILPA REDDY

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

Individual Professional Information
NPI	1013367416
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7517297344
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190923000131
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	REDDY
	Individual professional last name
Provider First Name	SHILPA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2012
	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
Organization Legal Name	ST LUKES WARREN PHYSICIAN GROUP PC
	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	9739093675
	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	229
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	200 STRYKERS RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1
	Group Practice or individual's line 2 address
City	PHILLIPSBURG
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	088659488
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9088476568
	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	310060
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST. LUKE'S WARREN HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	390049
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ST LUKE'S HOSPITAL BETHLEHEM
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y