Physician Compare National (NPI:1427074343)

HEALTHCARE PROVIDER: MAGENDRA THAKUR 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	1427074343
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5092787440
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040806001189
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	THAKUR
	Individual professional last name
Provider First Name	MAGENDRA
	Individual professional first name
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	OTHER
	Individual professional's medical school
Graduation Year	1980
	Individual professional's medical school graduation year
Primary Specialty	SLEEP MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	7957 US HWY 11
	Group Practice or individual's line 1 address
City	POTSDAM
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	136763239
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3152681644
	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	330197
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CANTON-POTSDAM HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330223
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MASSENA MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	331315
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	GOUVERNEUR HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	330084
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	ALICE HYDE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y