Physician Compare National (NPI:1386788404)

HEALTHCARE PROVIDER: ALEXANDER HEISMAN MD

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

Individual Professional Information
NPI	1386788404
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0941333033
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100726000641
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HEISMAN
	Individual professional last name
Provider First Name	ALEXANDER
	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	1976
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	520 FRANKLIN AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 215
	Group Practice or individual's line 2 address
City	GARDEN CITY
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	115305815
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	330169
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MOUNT SINAI BETH ISRAEL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330019
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	NEW YORK COMMUNITY HOSPITAL OF BROOKLYN, INC.
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y