Physician Compare National (NPI:1144289398)

HEALTHCARE PROVIDER: KHALIDA SHARAFI 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	1144289398
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3072701085
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101217000033
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SHARAFI
	Individual professional last name
Provider First Name	KHALIDA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	RUTGERS R W JOHNSON MEDICAL SCHOOL (CAM/NEW BRUNS/PISC)
	Individual professional's medical school
Graduation Year	1995
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	LIFELINE MEDICAL ASSOCIATES 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	1456332170
	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	131
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	101 MADISON AVE
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	MORRISTOWN
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	079607305
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	310015
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MORRISTOWN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	310050
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y