Physician Compare National (NPI:1053558676)

HEALTHCARE PROVIDER: MUHAMMAD TALHA KHAN 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	1053558676
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7618191958
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140609000304
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KHAN
	Individual professional last name
Provider First Name	MUHAMMAD
	Individual professional first name
Provider Middle Name	TALHA
	Individual professional middle 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	2004
	Individual professional's medical school graduation year
Primary Specialty	PULMONARY DISEASE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	SLEEP MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	SLEEP MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	LADD MEMORIAL HOSPITAL
	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	9931092848
	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	22
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2600 65TH AVE
	Group Practice or individual's line 1 address
City	OSCEOLA
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	540204370
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7152942111
	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	521337
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST CROIX REGIONAL MEDICAL CTR
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	521318
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LADD MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	521331
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	BURNETT MEDICAL CENTER INC
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y