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Physician Compare National (NPI:1477752517)

HEALTHCARE PROVIDER: RAJEEV PATHAK MISRA D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1477752517
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 2365685039
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20130828000071
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name MISRA
Individual professional last name
Provider First Name RAJEEV
Individual professional first name
Provider Middle Name P
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 2007
Individual professional's medical school graduation year
Primary Specialty GENERAL SURGERY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name FRANCISCAN MEDICAL GROUP
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 0547173866
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 990
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 2200 NW MYHRE RD
Group Practice or individual's line 1 address
City SILVERDALE
Group Practice or individual's city
State WA
Group Practice or individual's state
Zip Code 983837681
Group Practice or individual's zip code (9 digits when available)
Phone Number 3608301100
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 500039
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 HARRISON MEDICAL CENTER
Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment Y

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