Physician Compare National (NPI:1093728206)

HEALTHCARE PROVIDER: SHANE MICHAEL HARTMAN MPT

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

Individual Professional Information
NPI	1093728206
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6103884085
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20061228000133
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HARTMAN
	Individual professional last name
Provider First Name	SHANE
	Individual professional first name
Provider Middle Name	MICHAEL
	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	2003
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL THERAPY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2297 KANSAS AVE SE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 4
	Group Practice or individual's line 2 address
City	HURON
	Group Practice or individual's city
State	SD
	Group Practice or individual's state
Zip Code	573504274
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y