Physician Compare National (NPI:1215990932)

HEALTHCARE PROVIDER: JAHANYAR KHORSANDI 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	1215990932
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0143205542
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040621000940
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KHORSANDI
	Individual professional last name
Provider First Name	JAHANYAR
	Individual professional first 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	LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	MED ED OF LOUISIANA INC
	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	9739164351
	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	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1310 S UNION ST
	Group Practice or individual's line 1 address
Line 2 Street Address	3 MED ED OF LOUISIANA INC OPELOUSAS
	Group Practice or individual's line 2 address
City	OPELOUSAS
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	705705612
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3376784000
	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	191302
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST MARTIN HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	190002
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LAFAYETTE GENERAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y