Physician Compare National (NPI:1467616128)

HEALTHCARE PROVIDER: LAKSHMI KANT PATHAK 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	1467616128
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7113198706
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20141028002410
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PATHAK
	Individual professional last name
Provider First Name	LAKSHMI
	Individual professional first name
Provider Middle Name	K
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1994
	Individual professional's medical school graduation year
Primary Specialty	NEPHROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	SANFORD MEDICAL CENTER FARGO
	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	8426967803
	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	729
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	5225 23RD AVE S
	Group Practice or individual's line 1 address
City	FARGO
	Group Practice or individual's city
State	ND
	Group Practice or individual's state
Zip Code	581047927
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7014172575
	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	350011
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SANFORD MEDICAL CENTER FARGO
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	351335
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	JAMESTOWN REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	241373
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	PERHAM HEALTH
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	241304
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	SANFORD WHEATON MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	351329
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	SANFORD HILLSBORO
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1467616128)

HEALTHCARE PROVIDER: LAKSHMI KANT PATHAK MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information