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Physician Compare National (NPI:1760515803)

HEALTHCARE PROVIDER: SANJEEV PRAKASH 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 1760515803
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 5799843439
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20081023000653
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name PRAKASH
Individual professional last name
Provider First Name SANJEEV
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 RHEUMATOLOGY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 4705 TOWNE CENTRE RD
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 303
Group Practice or individual's line 2 address
City SAGINAW
Group Practice or individual's city
State MI
Group Practice or individual's state
Zip Code 486042821
Group Practice or individual's zip code (9 digits when available)
Phone Number 9897976700
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 230070
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 COVENANT MEDICAL CENTER
Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2 230041
Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2 MCLAREN BAY REGION
Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3 230100
Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3 TAWAS ST JOSEPH HOSPITAL
Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4 230121
Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4 MEMORIAL HEALTHCARE
Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5 230077
Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5 ST MARY'S OF MICHIGAN MEDICAL CENTER
Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment Y

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