Physician Compare National (NPI:1366450579)

HEALTHCARE PROVIDER: SHATISHKUMAR Y PATEL 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	1366450579
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7719870088
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120918000163
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PATEL
	Individual professional last name
Provider First Name	SHATISHKUMAR
	Individual professional first name
Provider Middle Name	Y.
	Individual professional middle 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	1990
	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
Line 1 Street Address	8200 WEDNESBURY LN
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 290
	Group Practice or individual's line 2 address
City	HOUSTON
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	770742906
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450644
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WEST HOUSTON MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450820
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HOUSTON METHODIST SUGARLAND HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y