Physician Compare National (NPI:1891731667)

HEALTHCARE PROVIDER: NIKOLAI ALEXANDROVICH PODOLTSEV M.D., PH.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	1891731667
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9931109683
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070103000551
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PODOLTSEV
	Individual professional last name
Provider First Name	NIKOLAI
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1993
	Individual professional's medical school graduation year
Primary Specialty	MEDICAL ONCOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	HEMATOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	HEMATOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	YALE UNIVERSITY
	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	9436061736
	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	1883
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1450 CHAPEL ST B
	Group Practice or individual's line 1 address
City	NEW HAVEN
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	065114405
	Group Practice or individual's zip code (9 digits when available)
Phone Number	20386754204405
	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	070022
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	YALE-NEW HAVEN HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	070018
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	GREENWICH HOSPITAL ASSOCIATION -
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	070007
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	LAWRENCE & MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	070010
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	BRIDGEPORT HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y