Physician Compare National (NPI:1841428752)

HEALTHCARE PROVIDER: SRINIVAS MAHESH KATTA 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	1841428752
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4385878412
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150112000114
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KATTA
	Individual professional last name
Provider First Name	SRINIVAS MAHESH
	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	2002
	Individual professional's medical school graduation year
Primary Specialty	NEPHROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	300 ROCKEFELLER DR
	Group Practice or individual's line 1 address
City	MUSKOGEE
	Group Practice or individual's city
State	OK
	Group Practice or individual's state
Zip Code	744015075
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	370166
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WAGONER COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	370025
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SAINT FRANCIS HOSPITAL MUSKOGEE
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	370114
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ST JOHN MEDICAL CENTER, INC
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	280065
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	GREAT PLAINS HEALTH
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y