Physician Compare National (NPI:1457342966)

HEALTHCARE PROVIDER: BILLY WADE MAHANEY 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	1457342966
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4789816331
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200520003498
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MAHANEY
	Individual professional last name
Provider First Name	BILLY
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIFORMED SERVICES UHS FE HEBERT SCHOOL OF MED
	Individual professional's medical school
Graduation Year	2001
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	RADIOLOGY PHYSICIAN SOLUTIONS OF WEST FLORIDA 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	3577876218
	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	119
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2020 59TH ST W
	Group Practice or individual's line 1 address
City	BRADENTON
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	342094604
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8004372672
	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	200021
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MID COAST HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	210012
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SINAI HOSPITAL OF BALTIMORE
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	230165
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ST JOHN HOSPITAL AND MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	210040
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	NORTHWEST HOSPITAL CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	210057
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	ADVENTIST HEALTHCARE SHADY GROVE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1457342966)

HEALTHCARE PROVIDER: BILLY WADE MAHANEY M.D.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information