Physician Compare National (NPI:1740227255)

HEALTHCARE PROVIDER: MICHAEL ALT DO

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

Individual Professional Information
NPI	1740227255
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1759451487
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080606000039
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ALT
	Individual professional last name
Provider First Name	MICHAEL
	Individual professional first name
Provider Middle Name	G
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
	Individual professional's medical school
Graduation Year	1982
	Individual professional's medical school graduation year
Primary Specialty	NEUROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2934 BRECKENRIDGE LN
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 2
	Group Practice or individual's line 2 address
City	LOUISVILLE
	Group Practice or individual's city
State	KY
	Group Practice or individual's state
Zip Code	402203903
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	180130
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BAPTIST HEALTH LOUISVILLE
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	180088
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	NORTON HOSPITALS, INC
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	180016
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	JEWISH HOSPITAL - SHELBYVILLE
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y