Physician Compare National (NPI:1174815997)

HEALTHCARE PROVIDER: XIXI WONG M.D.

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

Individual Professional Information
NPI	1174815997
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0648560607
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180606001609
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WONG
	Individual professional last name
Provider First Name	XIXI
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	20 CEDAR BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 410
	Group Practice or individual's line 2 address
City	PITTSBURGH
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	152281330
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	390164
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	UPMC PRESBYTERIAN SHADYSIDE
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y