Physician Compare National (NPI:1811316458)

HEALTHCARE PROVIDER: SHIMA GHAVIMI 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	1811316458
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3577852193
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200819000682
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GHAVIMI
	Individual professional last name
Provider First Name	SHIMA
	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	2008
	Individual professional's medical school graduation year
Primary Specialty	GASTROENTEROLOGY
	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	UNIVERSITY PHYSICIANS AND SURGEONS, 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	2961315734
	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	300
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1249 15TH ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 3000
	Group Practice or individual's line 2 address
City	HUNTINGTON
	Group Practice or individual's city
State	WV
	Group Practice or individual's state
Zip Code	257013663
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3046911000
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y