Physician Compare National (NPI:1053666420)

HEALTHCARE PROVIDER: KHURRAM MIRZA

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

Individual Professional Information
NPI	1053666420
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2860709938
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200218001816
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MIRZA
	Individual professional last name
Provider First Name	KHURRAM
	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	2011
	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
Organization Legal Name	HOSPITAL MEDICINE ASSOCIATES LLC
	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	9234156985
	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	187
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	50 MEDICAL PARK DR E
	Group Practice or individual's line 1 address
City	BIRMINGHAM
	Group Practice or individual's city
State	AL
	Group Practice or individual's state
Zip Code	352353401
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2058383000
	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	010011
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST. VINCENT'S EAST
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	010056
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ST VINCENT'S BIRMINGHAM
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	100200
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	BROWARD HEALTH IMPERIAL POINT
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	010089
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	WALKER BAPTIST MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y