Physician Compare National (NPI:1750557310)

HEALTHCARE PROVIDER: JOE K AHN 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	1750557310
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3870663560
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080606000605
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	AHN
	Individual professional last name
Provider First Name	JOE
	Individual professional first name
Provider Middle Name	K
	Individual professional middle 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	2002
	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
Organization Legal Name	MEDICOR LIFESTYLE MEDICINE, P.A
	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	7911250956
	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	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	331 US HWY 206
	Group Practice or individual's line 1 address
City	HILLSBOROUGH
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	088444781
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9082435004
	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	310048
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL - SOMERSET
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	310015
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MORRISTOWN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	310038
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y