Physician Compare National (NPI:1477714525)

HEALTHCARE PROVIDER: ELAN DAHL BOMSZTYK 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	1477714525
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6406072669
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140723002289
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BOMSZTYK
	Individual professional last name
Provider First Name	ELAN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	JS WEILL MEDICAL COLLEGE, CORNELL UNIVERSITY
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERVENTIONAL RADIOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERVENTIONAL RADIOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	SHELIN AGRAWAL AND HYER PLLC
	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	5890955959
	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	80
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2020 PALOMINO LN
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	LAS VEGAS
	Group Practice or individual's city
State	NV
	Group Practice or individual's state
Zip Code	891064894
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	290046
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SPRING VALLEY HOSPITAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	290054
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CENTENNIAL HILLS HOSPITAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	290057
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HENDERSON HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	290021
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	VALLEY HOSPITAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	291311
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	DESERT VIEW HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1477714525)

HEALTHCARE PROVIDER: ELAN DAHL BOMSZTYK MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information