Physician Compare National (NPI:1548473911)

HEALTHCARE PROVIDER:

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1548473911
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2264500891
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20081008000664
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GOLI
	Individual professional last name
Provider First Name	ALI
	Individual professional first name
Provider Middle Name	H
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1990
	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
Line 1 Street Address	125 NEWBURY ST
	Group Practice or individual's line 1 address
City	FRAMINGHAM
	Group Practice or individual's city
State	MA
	Group Practice or individual's state
Zip Code	017014592
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5085329203
	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	220090
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MILFORD REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	220175
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	METROWEST MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y