Physician Compare National (NPI:1043232663)

HEALTHCARE PROVIDER: LALITA A MATTA M.D.

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

Individual Professional Information
NPI	1043232663
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2769644335
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120426000305
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MATTA
	Individual professional last name
Provider First Name	LALITA
	Individual professional first name
Provider Middle Name	A
	Individual professional middle 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	1985
	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	65 FREMONT ST
	Group Practice or individual's line 1 address
City	MARLBOROUGH
	Group Practice or individual's city
State	MA
	Group Practice or individual's state
Zip Code	017521271
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	220049
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	220163
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	220090
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MILFORD REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	220175
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	METROWEST MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y