Physician Compare National (NPI:1821181090)

HEALTHCARE PROVIDER: SURESKUMAR D DESAI MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1821181090
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5890820047
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100315000013
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DESAI
	Individual professional last name
Provider First Name	SURESKUMAR
	Individual professional first name
Provider Middle Name	D
	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	1962
	Individual professional's medical school graduation year
Primary Specialty	PULMONARY DISEASE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	570 MEMORIAL CIR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 140
	Group Practice or individual's line 2 address
City	ORMOND BEACH
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	321745063
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100068
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100017
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HALIFAX HEALTH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	100118
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	FLORIDA HOSPITAL FLAGLER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	100014
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	FLORIDA HOSPITAL NEW SMYRNA
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y