Physician Compare National (NPI:1306863055)

HEALTHCARE PROVIDER: ANUPAMA PANT DHODAPKAR 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	1306863055
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7911953971
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050323000893
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PANT DHODAPKAR
	Individual professional last name
Provider First Name	ANUPAMA
	Individual professional first name
Provider Gender	F
	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	OTHER
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	MEDICAL ONCOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	HEMATOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	HEMATOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	BAYLOR ST LUKES MEDICAL GROUP
	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	9133213192
	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	175
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	100 B MEDICAL DR
	Group Practice or individual's line 1 address
City	LAKE JACKSON
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	775665674
	Group Practice or individual's zip code (9 digits when available)
Phone Number	71379817502
	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	450072
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CHI ST. LUKES' BRAZOSPORT HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450465
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MATAGORDA REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y