Physician Compare National (NPI:1689754426)

HEALTHCARE PROVIDER: IRAJ GOLZARI 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	1689754426
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6709069529
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110331000421
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GOLZARI
	Individual professional last name
Provider First Name	IRAJ
	Individual professional first 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	1975
	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	1869 S TAMIAMI TRAIL
	Group Practice or individual's line 1 address
City	VENICE
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	342933137
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100070
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	VENICE REGIONAL BAYFRONT HEALTH
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100087
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SARASOTA MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y