Physician Compare National (NPI:1790191831)

HEALTHCARE PROVIDER: MATTHEW DOTHAGER 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	1790191831
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6709179278
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180307001548
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DOTHAGER
	Individual professional last name
Provider First Name	MATTHEW
	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	2014
	Individual professional's medical school graduation year
Primary Specialty	HOSPITALIST
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	SALINA REGIONAL HEALTH CENTER 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	0446168215
	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	129
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	400 S SANTA FE AVE
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	SALINA
	Group Practice or individual's city
State	KS
	Group Practice or individual's state
Zip Code	674014144
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	170013
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HAYS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	170191
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	GREAT BEND REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	171355
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	TREGO COUNTY LEMKE MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	171325
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	GRAHAM COUNTY HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	171311
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	ROOKS COUNTY HEALTH CENTER
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1790191831)

HEALTHCARE PROVIDER: MATTHEW DOTHAGER M.D.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information