Physician Compare National (NPI:1053548891)

HEALTHCARE PROVIDER: AMIT MORI 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	1053548891
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7719135706
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180821000630
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MORI
	Individual professional last name
Provider First Name	AMIT
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2005
	Individual professional's medical school graduation year
Primary Specialty	GASTROENTEROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	6900 LAKE WOODLANDS DR
	Group Practice or individual's line 1 address
Line 2 Street Address	APT 511
	Group Practice or individual's line 2 address
City	THE WOODLANDS
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	773822842
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450684
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MEMORIAL HERMANN NORTHEAST
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450638
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HOUSTON NORTHWEST MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y