Physician Compare National (NPI:1811050644)

HEALTHCARE PROVIDER: MANJULA TELLA 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	1811050644
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3375671993
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100503000078
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TELLA
	Individual professional last name
Provider First Name	MANJULA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1983
	Individual professional's medical school graduation year
Primary Specialty	NEUROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2735 N CLARKSON ST
	Group Practice or individual's line 1 address
City	FREMONT
	Group Practice or individual's city
State	NE
	Group Practice or individual's state
Zip Code	680257717
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	280077
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	FREMONT HEALTH
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	280111
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	COLUMBUS COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	280125
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	FAITH REGIONAL HEALTH SERVICES
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	281359
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	MEMORIAL COMMUNITY HOSPITAL MCH & HEALTH SYSTEM
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y