Physician Compare National (NPI:1518976323)

HEALTHCARE PROVIDER: SAVITHA SUSARLA 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	1518976323
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1254349715
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20060327000108
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SUSARLA
	Individual professional last name
Provider First Name	SAVITHA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	DO
	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	KANSAS CITY COLLEGE OF MEDICINE AND SURGERY
	Individual professional's medical school
Graduation Year	2001
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	V SUSARLA MDSC
	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	2860400348
	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	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	860 SUMMIT ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 123
	Group Practice or individual's line 2 address
City	ELGIN
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	601204350
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8477410026
	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	140030
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ADVOCATE SHERMAN HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140217
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PRESENCE SAINT JOSEPH HOSPITAL - ELGIN
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y