Physician Compare National (NPI:1114999323)

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	1114999323
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3173577210
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050310000825
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MONDROW
	Individual professional last name
Provider First Name	DANIEL
	Individual professional first name
Provider Middle Name	N
	Individual professional middle 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	OTHER
	Individual professional's medical school
Graduation Year	1976
	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	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	CRITICAL CARE (INTENSIVISTS)
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CARDIOVASCULAR DISEASE (CARDIOLOGY), CRITICAL CARE (INTENSIVISTS)
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	65 JAMES ST
	Group Practice or individual's line 1 address
City	EDISON
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	088203947
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7323217000
	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	310108
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	JFK MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	310039
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	RARITAN BAY MEDICAL CENTER PERTH AMBOY DIVISION
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y