Physician Compare National (NPI:1700265030)

HEALTHCARE PROVIDER: SHAHZAD CHAUDHARY 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	1700265030
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3779835103
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20181011002159
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHAUDHARY
	Individual professional last name
Provider First Name	SHAHZAD
	Individual professional first name
Provider Middle Name	A
	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	2015
	Individual professional's medical school graduation year
Primary Specialty	HOSPITALIST
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	CITY MEDICAL OF UPPER EAST SIDE, 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	0648465039
	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	544
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	656 N WELLWOOD AVE
	Group Practice or individual's line 1 address
City	LINDENHURST
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	117571676
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6312254227
	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	330185
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330106
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	NS/LIJ HS-NORTH SHORE UNIVERSITY HOSPITAL AT MANHASSET
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y