Physician Compare National (NPI:1730187808)

HEALTHCARE PROVIDER:

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1730187808
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1153353057
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050831000220
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PATEL
	Individual professional last name
Provider First Name	PRAKASH
	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.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1978
	Individual professional's medical school graduation year
Primary Specialty	RADIATION ONCOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	DIAGNOSTIC RADIOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	DIAGNOSTIC RADIOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	915 10TH ST
	Group Practice or individual's line 1 address
City	PORTSMOUTH
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	456624152
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	361326
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ADAMS COUNTY REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	360008
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SOUTHERN OHIO MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	360361
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	KINGS DAUGHTERS MEDICAL CENTER OHIO
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	360236
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	MERCY HOSPITAL CLERMONT
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	360234
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	MERCY HEALTH - WEST HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1730187808)

HEALTHCARE PROVIDER:

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information