Physician Compare National (NPI:1215290499)

HEALTHCARE PROVIDER: NAZAR E MOHAMED SANOUSI 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	1215290499
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7517181605
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140808002230
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MOHAMED SANOUSI
	Individual professional last name
Provider First Name	NAZAR
	Individual professional first name
Provider Middle Name	E
	Individual professional middle 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	1994
	Individual professional's medical school graduation year
Primary Specialty	GERIATRIC MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	FAMILY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	FAMILY MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	HOMETOWN HEALTH MANAGEMENT COMPANY
	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	0244139798
	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	123
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	75 PRINGLE WAY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 601
	Group Practice or individual's line 2 address
City	RENO
	Group Practice or individual's city
State	NV
	Group Practice or individual's state
Zip Code	895021472
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7759825000
	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	290001
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	RENOWN REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	290049
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	RENOWN SOUTH MEADOWS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y