Physician Compare National (NPI:1356536411)

HEALTHCARE PROVIDER: ADI LEIBA 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	1356536411
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1052444825
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100730000019
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LEIBA
	Individual professional last name
Provider First Name	ADI
	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	1997
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	NEPHROLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	NEPHROLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	MT AUBURN PROFESSIONAL SERVICES
	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	6103725031
	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	261
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	330 MOUNT AUBURN ST
	Group Practice or individual's line 1 address
City	CAMBRIDGE
	Group Practice or individual's city
State	MA
	Group Practice or individual's state
Zip Code	021385502
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y