Physician Compare National (NPI:1669769501)

HEALTHCARE PROVIDER: JUSTIN SETH HOLTZMAN 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	1669769501
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2062643596
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140327000131
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HOLTZMAN
	Individual professional last name
Provider First Name	JUSTIN
	Individual professional first name
Provider Middle Name	SETH
	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	2011
	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	HOSPITALIST
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	HOSPITALIST
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	875 MAIN ST
	Group Practice or individual's line 1 address
City	WEYMOUTH
	Group Practice or individual's city
State	MA
	Group Practice or individual's state
Zip Code	021901658
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	330136
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BASSETT HEALTHCARE
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	220016
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BAYSTATE FRANKLIN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	220046
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	BERKSHIRE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	220100
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	SOUTH SHORE HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	331305
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	O'CONNOR HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1669769501)

HEALTHCARE PROVIDER: JUSTIN SETH HOLTZMAN M.D.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information