Physician Compare National (NPI:1427344761)

HEALTHCARE PROVIDER: ASMA IFTIKHAR M.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	1427344761
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2163664715
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200420002388
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	IFTIKHAR
	Individual professional last name
Provider First Name	ASMA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2001
	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	NORTHSIDE PRIMARY CARE PROFESSIONAL SERVICES,LLC
	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	9638343924
	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	217
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3340 PADDOCK PKWY
	Group Practice or individual's line 1 address
City	SUWANEE
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	300249119
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6786796210
	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	330185
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	070028
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ST. VINCENT'S MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	330101
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	NEW YORK-PRESBYTERIAN HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	330195
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	NS/LIJ HS LONG ISLAND JEWISH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	330106
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	NS/LIJ HS-NORTH SHORE UNIVERSITY HOSPITAL AT MANHASSET
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1427344761)

HEALTHCARE PROVIDER: ASMA IFTIKHAR M.D.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information