Physician Compare National (NPI:1063591402)

HEALTHCARE PROVIDER: ANAND MANTRAVADI 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	1063591402
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1658471453
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100928001537
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MANTRAVADI
	Individual professional last name
Provider First Name	ANAND
	Individual professional first name
Provider Middle Name	V
	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
Primary Specialty	OPHTHALMOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	DELAWARE EYE CARE CENTER PA
	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	6002868767
	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	19
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	833 S GOVERNORS AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	DOVER OFFICE
	Group Practice or individual's line 2 address
City	DOVER
	Group Practice or individual's city
State	DE
	Group Practice or individual's state
Zip Code	199044158
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3026741121
	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	390331
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	080007
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BEEBE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y