Physician Compare National (NPI:1427344142)

HEALTHCARE PROVIDER: CARTER KEITH ANDERSEN O.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	1427344142
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5698031128
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20171117000971
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ANDERSEN
	Individual professional last name
Provider First Name	CARTER
	Individual professional first name
Provider Middle Name	KEITH
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	GOLETA VALLEY OPTOMETRY
	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	3971869405
	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	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	5122 HOLLISTER AVE
	Group Practice or individual's line 1 address
City	SANTA BARBARA
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	931112526
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y