Physician Compare National (NPI:1023465903)

HEALTHCARE PROVIDER: PETER H HANNA DPM

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

Individual Professional Information
NPI	1023465903
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0840554507
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180503002361
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HANNA
	Individual professional last name
Provider First Name	PETER
	Individual professional first name
Provider Middle Name	H
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	BARRY UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	2016
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	975 BAPTIST WAY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 101
	Group Practice or individual's line 2 address
City	HOMESTEAD
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	330337600
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3052464774
	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	100022
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	JACKSON HEALTH SYSTEM
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100181
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LARKIN COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y