Physician Compare National (NPI:1730107715)

HEALTHCARE PROVIDER: UDAY SHAH 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	1730107715
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4880783000
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100720000611
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SHAH
	Individual professional last name
Provider First Name	UDAY
	Individual professional first name
Provider Middle Name	B
	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	1971
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	7550 HOHMAN AVE
	Group Practice or individual's line 1 address
City	MUNSTER
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	463211060
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	150004
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	FRANCISCAN ST. MARGARET HEALTH HAMMOND
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140048
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ADVOCATE TRINITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y