Physician Compare National (NPI:1154529402)

HEALTHCARE PROVIDER: JOSI AMANDA WAGNER BERMAN M.S., CCC-SLP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1154529402
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2668605023
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140509000671
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WAGNER BERMAN
	Individual professional last name
Provider First Name	JOSI
	Individual professional first name
Provider Middle Name	AMANDA
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1999
	Individual professional's medical school graduation year
Primary Specialty	QUALIFIED SPEECH LANGUAGE PATHOLOGIST
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	626 GOLDEN EAGLE CIR
	Group Practice or individual's line 1 address
City	GOLDEN
	Group Practice or individual's city
State	CO
	Group Practice or individual's state
Zip Code	804010909
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y