Physician Compare National (NPI:1467557793)

HEALTHCARE PROVIDER: ROBERTA PERSAUD 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	1467557793
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8628193505
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100915000864
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PERSAUD
	Individual professional last name
Provider First Name	ROBERTA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	INFECTIOUS DISEASE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	29099 HEALTH CAMPUS DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 120
	Group Practice or individual's line 2 address
City	WESTLAKE
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	441455255
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4408356169
	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	360123
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST JOHN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	360145
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	UNIVERSITY HOSPITALS - ELYRIA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y