Physician Compare National (NPI:1184945982)

HEALTHCARE PROVIDER: ANGELA PENNISI 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	1184945982
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2365768330
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190726001059
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PENNISI
	Individual professional last name
Provider First Name	ANGELA
	Individual professional first 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	2002
	Individual professional's medical school graduation year
Primary Specialty	HEMATOLOGY/ONCOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	INOVA HEALTH CARE SERVICES
	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	2466351093
	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	967
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	8081 INNOVATION PARK DR
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	FAIRFAX
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	220314867
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	490063
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	INOVA FAIRFAX HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	490101
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	INOVA FAIR OAKS HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y