Physician Compare National (NPI:1124256359)

HEALTHCARE PROVIDER: BENJAMIN EDWARD NORTHRUP 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	1124256359
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3072741834
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140429001074
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	NORTHRUP
	Individual professional last name
Provider First Name	BENJAMIN
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	GEISEL SCHOOL OF MEDICINE AT DARTMOUTH
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	NATIONAL DIAGNOSTIC IMAGING, 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	4880655521
	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	18
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	7140 N NATIONAL DR
	Group Practice or individual's line 1 address
Line 2 Street Address	DR. BENJAMIN NORTHRUP
	Group Practice or individual's line 2 address
City	PARKVILLE
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	641524986
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2165141199
	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	260096
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORTH KANSAS CITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	170040
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	UNIVERSITY OF KANSAS HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y