Physician Compare National (NPI:1790742344)

HEALTHCARE PROVIDER: RAM GOPAL MALLADI 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	1790742344
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9335264779
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100909000140
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MALLADI
	Individual professional last name
Provider First Name	RAM
	Individual professional first name
Provider Middle Name	GOPAL
	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	1971
	Individual professional's medical school graduation year
Primary Specialty	OTOLARYNGOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ALLERGY/IMMUNOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ALLERGY/IMMUNOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	10 HOSPITAL DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 106
	Group Practice or individual's line 2 address
City	HOLYOKE
	Group Practice or individual's city
State	MA
	Group Practice or individual's state
Zip Code	010406612
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	220024
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HOLYOKE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	220015
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	COOLEY DICKINSON HOSPITAL INC,THE
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	220065
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	BAYSTATE NOBLE HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	220077
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	BAYSTATE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y