Physician Compare National (NPI:1639175375)

HEALTHCARE PROVIDER: JEFFREY A CHAITOFF 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	1639175375
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9234227117
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20071109000256
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHAITOFF
	Individual professional last name
Provider First Name	JEFFREY
	Individual professional first name
Provider Middle Name	ALAN
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1970
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ADDICTION MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	RHEUMATOLOGY
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ADDICTION MEDICINE, RHEUMATOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	6563 WILSON MILLS RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 104
	Group Practice or individual's line 2 address
City	MAYFIELD VILLAGE
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	441433409
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	360230
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HILLCREST HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	360180
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CLEVELAND CLINIC
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y