Physician Compare National (NPI:1265662969)

HEALTHCARE PROVIDER: ARPANA EDALA 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	1265662969
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0941324487
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100903000918
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	EDALA
	Individual professional last name
Provider First Name	ARPANA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2000
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ARKANSAS LONGEVITY CENTER PLLC
	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	4183993082
	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	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1 SAINT VINCENT CIR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 150
	Group Practice or individual's line 2 address
City	LITTLE ROCK
	Group Practice or individual's city
State	AR
	Group Practice or individual's state
Zip Code	722055406
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	040084
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SALINE MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	040114
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BAPTIST HEALTH MEDICAL CENTER-LITTLE ROCK
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y