Physician Compare National (NPI:1538178264)

HEALTHCARE PROVIDER: SANJAY GHOSH PHD 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	1538178264
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6507945912
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080509000105
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GHOSH
	Individual professional last name
Provider First Name	SANJAY
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	RHEUMATOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1080 CAROLINE DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 200
	Group Practice or individual's line 2 address
City	WASHINGTON
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	630904902
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	260052
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MERCY HOSPITAL WASHINGTON
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	261337
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MISSOURI BAPTIST SULLIVAN HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y