Physician Compare National (NPI:1114364064)

HEALTHCARE PROVIDER: ALEXANDER J TATEM 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	1114364064
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5698917029
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190805000566
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TATEM
	Individual professional last name
Provider First Name	ALEXANDER
	Individual professional first name
Provider Middle Name	JAMES
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	UROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	UROLOGY OF INDIANA 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	7517870009
	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	57
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	8240 NAAB RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 220
	Group Practice or individual's line 2 address
City	INDIANAPOLIS
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	462601950
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8773622778
	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	150074
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	COMMUNITY HOSPITAL EAST
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	150169
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	COMMUNITY HOSPITAL NORTH
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	150161
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	INDIANA UNIVERSITY HEALTH NORTH HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	150056
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	INDIANA UNIVERSITY HEALTH METHODIST HOSPITAL (INDIANAPOLIS)
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y