Physician Compare National (NPI:1205891116)

HEALTHCARE PROVIDER: ROBERT MILETICH 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	1205891116
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9537056627
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040701000422
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MILETICH
	Individual professional last name
Provider First Name	ROBERT
	Individual professional first name
Provider Middle Name	S
	Individual professional middle name
Provider Gender	M
	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	UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	NEUROLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	NEUROLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	105 PARKER HALL
	Group Practice or individual's line 1 address
City	BUFFALO
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	142148004
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	330005
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	KALEIDA HEALTH
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y