Physician Compare National (NPI:1093748360)

HEALTHCARE PROVIDER: RIZKALLA A. MOUCHATI MD

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

Individual Professional Information
NPI	1093748360
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1052492360
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080112000069
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MOUCHATI
	Individual professional last name
Provider First Name	RIZKALLA
	Individual professional first name
Provider Middle Name	A
	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	1979
	Individual professional's medical school graduation year
Primary Specialty	NEUROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	500 CONGRESS ST
	Group Practice or individual's line 1 address
Line 2 Street Address	1H
	Group Practice or individual's line 2 address
City	QUINCY
	Group Practice or individual's city
State	MA
	Group Practice or individual's state
Zip Code	021690917
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6177860066
	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	220108
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BETH ISRAEL DEACONESS HOSPITAL - MILTON
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y