Physician Compare National (NPI:1386733764)

HEALTHCARE PROVIDER: SUSAN DORSEY

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

Individual Professional Information
NPI	1386733764
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6800979006
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080212000048
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DORSEY
	Individual professional last name
Provider First Name	SUSAN
	Individual professional first name
Provider Middle Name	S
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1987
	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	COMMUNITY CARE PHYSICIANS PC
	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	8022904473
	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	316
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	713 TROY SCHENECTADY RD
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	LATHAM
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	121102490
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	330222
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SARATOGA HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330180
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SAMARITAN HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	330191
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	GLENS FALLS HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y