Physician Compare National (NPI:1730490525)

HEALTHCARE PROVIDER: AMARDEEP SHRESTHA 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	1730490525
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2668611575
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130625000208
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SHRESTHA
	Individual professional last name
Provider First Name	AMARDEEP
	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	2006
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1480 N GREEN MOUNT RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 200
	Group Practice or individual's line 2 address
City	O FALLON
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	622693466
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140187
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HSHS ST ELIZABETH'S HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140185
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	140307
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	METRO-EAST SERVICES INC
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y