Physician Compare National (NPI:1023356425)

HEALTHCARE PROVIDER: EMMA SAMEERA EDWARDS P.A.

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

Individual Professional Information
NPI	1023356425
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1850513417
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20141114001120
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	EDWARDS
	Individual professional last name
Provider First Name	EMMA
	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	PHYSICIAN ASSISTANT
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	BELLEVUE FAMILY PRACTICE 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	3476450032
	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	4
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2206 LONGO DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 201
	Group Practice or individual's line 2 address
City	BELLEVUE
	Group Practice or individual's city
State	NE
	Group Practice or individual's state
Zip Code	680052977
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4022929170
	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	280003
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BRYAN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	280111
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	COLUMBUS COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	280020
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	CHI HEALTH ST. ELIZABETH
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y