Physician Compare National (NPI:1396736971)

HEALTHCARE PROVIDER: ALBERT D SAM II 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	1396736971
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3971495151
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200507002014
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SAM
	Individual professional last name
Provider First Name	ALBERT
	Individual professional first name
Provider Middle Name	DEVON
	Individual professional middle name
Provider Name Suffix Text	II
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	DUKE UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1993
	Individual professional's medical school graduation year
Primary Specialty	VASCULAR SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	INOVA HEALTH CARE 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	2466351093
	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	967
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	8140 ASHTON AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 125
	Group Practice or individual's line 2 address
City	MANASSAS
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	201095700
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7032805858
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	490122
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	INOVA MOUNT VERNON HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	490040
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	INOVA ALEXANDRIA HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	490063
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	INOVA FAIRFAX HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y