Physician Compare National (NPI:1134178643)

HEALTHCARE PROVIDER: SURAJ MATHEW CHERRY 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	1134178643
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0840264792
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050608000443
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHERRY
	Individual professional last name
Provider First Name	SURAJ
	Individual professional first name
Provider Middle Name	M
	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	BOSTON UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2000
	Individual professional's medical school graduation year
Primary Specialty	OPHTHALMOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3505 LONE TREE WAY
	Group Practice or individual's line 1 address
City	ANTIOCH
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	945096067
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9257784555
	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	050811
	Medicare CCN of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y