Physician Compare National (NPI:1104073345)

HEALTHCARE PROVIDER: FERAS KARADSHEH 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	1104073345
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7517107907
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160829003092
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KARADSHEH
	Individual professional last name
Provider First Name	FERAS
	Individual professional first name
Provider Middle Name	F
	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	2006
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	NEPHROLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	NEPHROLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	MGMC LLC
	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	9537073119
	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	474
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	7503 SURRATTS RD
	Group Practice or individual's line 1 address
City	CLINTON
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	207353358
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3018561682
	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	210062
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MEDSTAR SOUTHERN MARYLAND HOSPITAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	210035
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	UNIVERSITY OF MD CHARLES REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	090004
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MEDSTAR GEORGETOWN UNIVERSITY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	090011
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	MEDSTAR WASHINGTON HOSPITAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y