Physician Compare National (NPI:1144343708)

HEALTHCARE PROVIDER: SHALABH CHANDRA 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	1144343708
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0042357428
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180222000345
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHANDRA
	Individual professional last name
Provider First Name	SHALABH
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2003
	Individual professional's medical school graduation year
Primary Specialty	CARDIAC ELECTROPHYSIOLOGY
	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
All Secondary Specialties	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	HARTFORD HEALTHCARE MEDICAL GROUP SPECIALISTS 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	3173866241
	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	587
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	100 HAZARD AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 206
	Group Practice or individual's line 2 address
City	ENFIELD
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	060825447
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8607491985
	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	220077
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BAYSTATE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	220015
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	COOLEY DICKINSON HOSPITAL INC,THE
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	220024
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HOLYOKE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	220066
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	MERCY MEDICAL CTR
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y