Physician Compare National (NPI:1891131710)

HEALTHCARE PROVIDER: GUANGZU GAO 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	1891131710
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7517247018
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190530001624
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GAO
	Individual professional last name
Provider First Name	GUANGZU
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	HARVARD MEDICAL SCHOOL
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	COASTAL IMAGING LLC
	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	8123312055
	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	38
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1140 ROUTE 72 W
	Group Practice or individual's line 1 address
City	MANAHAWKIN
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	080502412
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6095976011
	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	310034
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	RIVERVIEW MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	310108
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	JFK MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	310073
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	JERSEY SHORE UNIVERSITY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	330154
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	MEMORIAL HOSPITAL FOR CANCER AND ALLIED DISEASES
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y