Physician Compare National (NPI:1710944707)

HEALTHCARE PROVIDER: HABIB FOUAD BASSIL 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	1710944707
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1355336173
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100830000812
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BASSIL
	Individual professional last name
Provider First Name	HABIB
	Individual professional first name
Provider Middle Name	F
	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
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	HALIFAX REGIONAL HOSPITAL INC
	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	4587572805
	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	6
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2204 WILBORN AVE
	Group Practice or individual's line 1 address
City	SOUTH BOSTON
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	245921645
	Group Practice or individual's zip code (9 digits when available)
Phone Number	43451731003433
	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	490013
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SENTARA HALIFAX REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y