Physician Compare National (NPI:1740246289)

HEALTHCARE PROVIDER: VENKATESWARA VELAGA 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	1740246289
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4183704265
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20081003000736
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	VELAGA
	Individual professional last name
Provider First Name	VENKATESWARA
	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	1979
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1600 CANTON ST
	Group Practice or individual's line 1 address
City	HOPKINSVILLE
	Group Practice or individual's city
State	KY
	Group Practice or individual's state
Zip Code	422401924
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	180051
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	JENNIE STUART MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	181304
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	TRIGG COUNTY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	440082
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SAINT THOMAS WEST HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y