Physician Compare National (NPI:1891059556)

HEALTHCARE PROVIDER: BIJAN ANDRADE DPM

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

Individual Professional Information
NPI	1891059556
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7416266366
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160217000823
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ANDRADE
	Individual professional last name
Provider First Name	BIJAN
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	108 N 11TH AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 2
	Group Practice or individual's line 2 address
City	BOZEMAN
	Group Practice or individual's city
State	MT
	Group Practice or individual's state
Zip Code	597153264
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8014196206
	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	270057
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BOZEMAN HEALTH DEACONESS HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	M