Physician Compare National (NPI:1487753877)

HEALTHCARE PROVIDER: PRITAM RAO POLKAMPALLY 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	1487753877
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5294974614
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20151218001982
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	POLKAMPALLY
	Individual professional last name
Provider First Name	PRITAM
	Individual professional first name
Provider Middle Name	R
	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	2000
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ATLANTA HEART ASSOCIATES
	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	6204737216
	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	18
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	483 UPPER RIVERDALE RD SW
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE C
	Group Practice or individual's line 2 address
City	RIVERDALE
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	302742579
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7709079009
	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	110191
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PIEDMONT HENRY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	110083
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PIEDMONT HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y