Physician Compare National (NPI:1548426810)

HEALTHCARE PROVIDER: VINAYA K. PUPPALA 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	1548426810
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6406086826
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140305000522
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PUPPALA
	Individual professional last name
Provider First Name	VINAYA
	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	WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	PAIN MANAGEMENT
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ANESTHESIOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ANESTHESIOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	705 DALLAS HWY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 205
	Group Practice or individual's line 2 address
City	VILLA RICA
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	301801243
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110042
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WELLSTAR PAULDING HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y