Physician Compare National (NPI:1508975293)

HEALTHCARE PROVIDER: NAGARAJ M CHETTY 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	1508975293
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8921994583
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040223000526
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHETTY
	Individual professional last name
Provider First Name	NAGARAJ
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1970
	Individual professional's medical school graduation year
Primary Specialty	GASTROENTEROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	15211 VANOWEN ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 209
	Group Practice or individual's line 2 address
City	VAN NUYS
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	914053624
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050278
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PROVIDENCE HOLY CROSS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050704
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MISSION COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	050126
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	VALLEY PRESBYTERIAN HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y