Physician Compare National (NPI:1528334786)

HEALTHCARE PROVIDER: OMAR NASSIM KHATIB 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	1528334786
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4385963875
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190725001539
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KHATIB
	Individual professional last name
Provider First Name	OMAR
	Individual professional first name
Provider Middle Name	NASSIM
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	ORTHOPEDIC SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	900 MAIN ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 130
	Group Practice or individual's line 2 address
City	PATERSON
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	075032619
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y