Physician Compare National (NPI:1871504647)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1871504647
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4082700059
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20071022000831
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BEESLEY
	Individual professional last name
Provider First Name	ROBERT
	Individual professional first name
Provider Middle Name	C
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	INDIANA UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1975
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2200 JOHN R WOODEN DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 204
	Group Practice or individual's line 2 address
City	MARTINSVILLE
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	461511838
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7653427164
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	360068
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PROMEDICA TOLEDO HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	150056
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	INDIANA UNIVERSITY HEALTH METHODIST HOSPITAL (INDIANAPOLIS)
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	150057
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	FRANCISCAN HEALTH MOORESVILLE
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	150162
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	FRANCISCAN HEALTH INDIANAPOLIS
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y