Physician Compare National (NPI:1063449221)

HEALTHCARE PROVIDER: NAGRAJ NARASIMHAN 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	1063449221
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3173430063
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070927000316
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	NARASIMHAN
	Individual professional last name
Provider First Name	NAGRAJ
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1980
	Individual professional's medical school graduation year
Primary Specialty	NEPHROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	IDAHO KIDNEY INSTITUTE LLP
	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	9032155312
	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	10
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	444 HOSPITAL WAY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 607
	Group Practice or individual's line 2 address
City	POCATELLO
	Group Practice or individual's city
State	ID
	Group Practice or individual's state
Zip Code	832012714
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2089044780
	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	130002
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST LUKES MAGIC VALLEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	131326
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CASSIA REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	131302
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	NORTH CANYON MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	131323
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	ST LUKE'S WOOD RIVER MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	131319
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	MINIDOKA MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1063449221)

HEALTHCARE PROVIDER: NAGRAJ NARASIMHAN M.D.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information