Physician Compare National (NPI:1265432611)

HEALTHCARE PROVIDER: MUTHUSAMY VELUSAMY 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	1265432611
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3971684382
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100819000875
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	VELUSAMY
	Individual professional last name
Provider First Name	MUTHUSAMY
	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	1985
	Individual professional's medical school graduation year
Primary Specialty	INTERVENTIONAL CARDIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	6328 GUNN HWY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE C
	Group Practice or individual's line 2 address
City	TAMPA
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	336254101
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100206
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MEMORIAL HOSPITAL OF TAMPA
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100256
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	REGIONAL MEDICAL CENTER BAYONET POINT
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	100265
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MORTON PLANT MEASE HEALTHCARE COUNTRYSIDE
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	100075
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	ST JOSEPHS HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	100063
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	MORTON PLANT NORTH BAY HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1265432611)

HEALTHCARE PROVIDER: MUTHUSAMY VELUSAMY MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information