Physician Compare National (NPI:1538144514)

HEALTHCARE PROVIDER: TIMOTHY O'BYRNE 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	1538144514
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5496821779
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080910000540
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	OBYRNE
	Individual professional last name
Provider First Name	TIMOTHY
	Individual professional first name
Provider Middle Name	K
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
	Individual professional's medical school
Graduation Year	1992
	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	CARDIOVASCULAR ASSOCIATES OF STATEN ISLAND LLC
	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	6406031558
	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	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	501 SEAVIEW AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	STATEN ISLAND
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	103053400
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7186670077
	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	330160
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	STATEN ISLAND UNIVERSITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y