Physician Compare National (NPI:1437473469)

HEALTHCARE PROVIDER: JAMES LEITHEAD III

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

Individual Professional Information
NPI	1437473469
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2062703564
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160613002342
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LEITHEAD
	Individual professional last name
Provider First Name	JAMES
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Name Suffix Text	III
	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.

Medical School Information
Medical School Name	LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
	Individual professional's medical school
Graduation Year	2010
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	SURGICAL SPECIALISTS OF LA
	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	4789581919
	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	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1570 LINDBERG DR
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	SLIDELL
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	704588084
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9856051100
	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	190270
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SOUTHERN SURGICAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	190005
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	UNIVERSITY MEDICAL CENTER NEW ORLEANS
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y