Physician Compare National (NPI:1114965597)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1114965597
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1254420318
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20181008002658
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WESA
	Individual professional last name
Provider First Name	KATHLEEN
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
	Individual professional's medical school
Graduation Year	1989
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ACCESS PHYSICIANS PLLC
	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	7810204831
	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	60
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1200 HOSPITAL DR
	Group Practice or individual's line 1 address
City	MOUNT PLEASANT
	Group Practice or individual's city
State	SC
	Group Practice or individual's state
Zip Code	294643251
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9724490540
	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	330386
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CATSKILL REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	331303
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CATSKILL REGIONAL MEDICAL CENTER - G HERMANN SITE
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y