Physician Compare National (NPI:1225042484)

HEALTHCARE PROVIDER: MOHAMMAD A. JAN 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	1225042484
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1658471362
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070723000641
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	JAN
	Individual professional last name
Provider First Name	MOHAMMED
	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	1967
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1176 E HOME RD
	Group Practice or individual's line 1 address
City	SPRINGFIELD
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	455032726
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	360070
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MERCY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	361302
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	TRINITY HOSPITAL TWIN CITY
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	M