Physician Compare National (NPI:1346498029)

HEALTHCARE PROVIDER: SIVHOUR LY OD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1346498029
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5496804098
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090529000470
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LY
	Individual professional last name
Provider First Name	SIVHOUR
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW ENGLAND COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	MASS OPTOMETRIC ASSOCIATES, 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	0648362442
	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	25
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	435 STATE RD
	Group Practice or individual's line 1 address
City	DARTMOUTH
	Group Practice or individual's city
State	MA
	Group Practice or individual's state
Zip Code	027474306
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5089963364
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y