Physician Compare National (NPI:1679777270)

HEALTHCARE PROVIDER: GUSHYALATHA BOYA 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	1679777270
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6608052626
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110509000579
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BOYA
	Individual professional last name
Provider First Name	GUSHYALATHA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MOREHOUSE SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	THE AUSTIN DIAGNOSTIC CLINIC PLLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	1254244551
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	116
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1250 S CAPITAL OF TEXAS HWY
	Group Practice or individual's line 1 address
Line 2 Street Address	BLDG 31
	Group Practice or individual's line 2 address
City	WEST LAKE HILLS
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	787466446
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5123342403
	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	450809
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORTH AUSTIN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450431
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ST DAVID'S MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y