Physician Compare National (NPI:1740225044)

HEALTHCARE PROVIDER: ANDREW I SHEDDEN 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	1740225044
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9234123282
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20131114000529
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SHEDDEN
	Individual professional last name
Provider First Name	ANDREW
	Individual professional first name
Provider Middle Name	I
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	INDIANA UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	RADIOLOGY ASSOCIATES OF BENNINGTON, 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	4981698933
	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	4
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	105 OLD SIEK RD
	Group Practice or individual's line 1 address
City	TROY
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	121809783
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5186635595
	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	470012
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SOUTHWESTERN VERMONT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y