Physician Compare National (NPI:1477514305)

HEALTHCARE PROVIDER: KELLY ANN WOOD 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	1477514305
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9234164518
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190501002016
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WOOD
	Individual professional last name
Provider First Name	KELLY
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1993
	Individual professional's medical school graduation year
Primary Specialty	CRITICAL CARE (INTENSIVISTS)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ROSWELL PARK CANCER INSTITUTE
	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	3577475110
	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	371
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	ELM AND CARLTON ST
	Group Practice or individual's line 1 address
City	BUFFALO
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	142630001
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7168452300
	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	330354
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ROSWELL PARK CANCER INSTITUTE
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	340002
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MEMORIAL MISSION HOSPITAL AND ASHEVILLE SURGERY CE
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y