Physician Compare National (NPI:1497834816)

HEALTHCARE PROVIDER: JAGDISH AMRATLAL SHAH 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	1497834816
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9133292592
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110218000049
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SHAH
	Individual professional last name
Provider First Name	JAGDISH
	Individual professional first 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	1980
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1220 E 6TH ST
	Group Practice or individual's line 1 address
City	BONHAM
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	754184017
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9035837424
	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	451370
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TMC- BONHAM HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450324
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	TEXOMA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y