Physician Compare National (NPI:1093122335)

HEALTHCARE PROVIDER: LILY AVGUSTOVSKIY

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

Individual Professional Information
NPI	1093122335
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6800118795
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160908002041
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	AVGUSTOVSKIY
	Individual professional last name
Provider First Name	LILY
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2014
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	BENEFIS HOSPITALS, INC.
	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	1153235296
	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	251
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2800 11TH AVE S
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	GREAT FALLS
	Group Practice or individual's city
State	MT
	Group Practice or individual's state
Zip Code	594055263
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	270012
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BENEFIS HOSPITALS INC
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	270086
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	GREAT FALLS CLINIC HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	270004
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	BILLINGS CLINIC
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	271324
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	PONDERA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	270032
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	NORTHERN MONTANA HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1093122335)

HEALTHCARE PROVIDER: LILY AVGUSTOVSKIY

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information