Physician Compare National (NPI:1477714665)

HEALTHCARE PROVIDER: NIRAV HASMUKH AMIN 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	1477714665
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2163739384
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150919000193
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	AMIN
	Individual professional last name
Provider First Name	NIRAV
	Individual professional first name
Provider Middle Name	HASMUKH
	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	2008
	Individual professional's medical school graduation year
Primary Specialty	SPORTS MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ORTHOPEDIC SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ORTHOPEDIC SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	PREMIER ORTHOPAEDIC TRAUMA SPECIALISTS, PMC
	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	4082992623
	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	8
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	160 E ARTESIA ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 255
	Group Practice or individual's line 2 address
City	POMONA
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	917672921
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9095964346
	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	050231
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	POMONA VALLEY HOSPITAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050069
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ST JOSEPH HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	050022
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	RIVERSIDE COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y