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Physician Compare National (NPI:1043246531)

HEALTHCARE PROVIDER: KESHAV R NAYAK 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 1043246531
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 6800199407
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20170927001019
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name NAYAK
Individual professional last name
Provider First Name KESHAV
Individual professional first name
Provider Middle Name R
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Individual professional's medical school
Graduation Year 1997
Individual professional's medical school graduation year
Primary Specialty INTERVENTIONAL CARDIOLOGY
Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1 CARDIOVASCULAR DISEASE (CARDIOLOGY)
First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties CARDIOVASCULAR DISEASE (CARDIOLOGY)
All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information

Line 1 Street Address 501 WASHINGTON ST
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 512
Group Practice or individual's line 2 address
City SAN DIEGO
Group Practice or individual's city
State CA
Group Practice or individual's state
Zip Code 921032238
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 050077
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 SCRIPPS MERCY HOSPITAL
Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2 050324
Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2 SCRIPPS MEMORIAL HOSPITAL LA JOLLA
Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3 050234
Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3 SHARP CORONADO HOSPITAL AND HLTHCR CTR
Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment Y

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