Physician Compare National (NPI:1174587950)

HEALTHCARE PROVIDER: HUMERA ALI 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	1174587950
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4981650033
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050322001139
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ALI
	Individual professional last name
Provider First Name	HUMERA
	Individual professional first name
Provider Gender	F
	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	OTHER
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	THE POLYCLINIC
	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	2163328196
	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	377
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	751 NE BLAKELY DR
	Group Practice or individual's line 1 address
Line 2 Street Address	4020 THE POLYCLINIC ISSAQUAH PHYSICAL MEDICINE
	Group Practice or individual's line 2 address
City	ISSAQUAH
	Group Practice or individual's city
State	WA
	Group Practice or individual's state
Zip Code	980296201
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2063259176
	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	500025
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SWEDISH MEDICAL CENTER / CHERRY HILL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	500152
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SWEDISH ISSAQUAH
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y