Physician Compare National (NPI:1215433495)

HEALTHCARE PROVIDER: AMISH PATEL DO

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

Individual Professional Information
NPI	1215433495
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9739418401
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190905000441
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PATEL
	Individual professional last name
Provider First Name	AMISH
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
	Individual professional's medical school
Graduation Year	2018
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	FARMERS UNION HOSPITAL ASSOCIATION
	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	7517949415
	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	25
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1801 W 3RD ST
	Group Practice or individual's line 1 address
Line 2 Street Address	3 GREAT PLAINS REGIONAL MEDICAL CENTER
	Group Practice or individual's line 2 address
City	ELK CITY
	Group Practice or individual's city
State	OK
	Group Practice or individual's state
Zip Code	736445145
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5802252511
	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	370054
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GRADY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	370019
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	GREAT PLAINS REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	370004
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	INTEGRIS MIAMI HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	370026
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	ST MARY'S REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y