Physician Compare National (NPI:1093936551)

HEALTHCARE PROVIDER: IFEANYI O ISAIAH 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	1093936551
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7113991050
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070829000061
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ISAIAH
	Individual professional last name
Provider First Name	IFEANYI
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	TEMPLE UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2001
	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
Line 1 Street Address	17325 NW 27TH AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 108
	Group Practice or individual's line 2 address
City	MIAMI GARDENS
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	330564000
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100281
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MEMORIAL HOSPITAL WEST
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100022
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	JACKSON HEALTH SYSTEM
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	100230
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MEMORIAL HOSPITAL PEMBROKE
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	100131
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	AVENTURA HOSPITAL AND MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	100029
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	NORTH SHORE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1093936551)

HEALTHCARE PROVIDER: IFEANYI O ISAIAH MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information