Physician Compare National (NPI:1225219462)

HEALTHCARE PROVIDER: GAURAV KUMAR 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	1225219462
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9638365653
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110629000618
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KUMAR
	Individual professional last name
Provider First Name	GAURAV
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	CRITICAL CARE (INTENSIVISTS)
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	PULMONARY DISEASE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE, PULMONARY DISEASE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	3156 WILLOWCREEK RD
	Group Practice or individual's line 1 address
City	PORTAGE
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	463684424
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	150034
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST MARY MEDICAL CENTER INC
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	150035
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PORTER REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	150015
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	FRANCISCAN ST ANTHONY HEALTH - MICHIGAN CITY
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	150002
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	METHODIST HOSPITALS INC
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	150102
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	INDIANA UNIVERSITY HEALTH STARKE HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1225219462)

HEALTHCARE PROVIDER: GAURAV KUMAR M.D.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information