Physician Compare National (NPI:1205195146)

HEALTHCARE PROVIDER: RAFIK BEN ABDA D.O

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

Individual Professional Information
NPI	1205195146
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8921221599
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180717003760
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BEN ABDA
	Individual professional last name
Provider First Name	RAFIK
	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	2012
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	BROOKS COUNTY HOSPITAL
	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	1557279049
	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	16
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	30 TIMBERLAND CIR
	Group Practice or individual's line 1 address
City	RICHMOND HILL
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	313246373
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9525951100
	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	420080
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HILTON HEAD REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450132
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MEDICAL CENTER HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	420101
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	COASTAL CAROLINA HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	110135
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	TAYLOR REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	390198
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	MILLCREEK COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1205195146)

HEALTHCARE PROVIDER: RAFIK BEN ABDA D.O

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information