Physician Compare National (NPI:1013957281)

HEALTHCARE PROVIDER: JEEVAKA YAPA DDS

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

Individual Professional Information
NPI	1013957281
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1052496940
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080318000133
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	YAPA
	Individual professional last name
Provider First Name	JEEVAKA
	Individual professional first name
Provider Middle Name	W
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MARQUETTE UNIVERSITY SCHOOL OF DENTISTRY
	Individual professional's medical school
Graduation Year	1991
	Individual professional's medical school graduation year
Primary Specialty	MAXILLOFACIAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ORAL SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ORAL SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	30555 GREENFIELD 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	480761594
	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
Professional Accepts Medicare Assignment	Y