Physician Compare National (NPI:1891742128)

HEALTHCARE PROVIDER: AJITH K KADAKOL 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	1891742128
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2062697402
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110428000033
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KADAKOL
	Individual professional last name
Provider First Name	AJITH
	Individual professional first name
Provider Middle Name	K
	Individual professional middle 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	1992
	Individual professional's medical school graduation year
Primary Specialty	VASCULAR SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1701 S BLVD E
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE B75
	Group Practice or individual's line 2 address
City	ROCHESTER HILLS
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	483076122
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	230047
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HENRY FORD MACOMB HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	230302
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HENRY FORD WEST BLOOMFIELD HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	230053
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HENRY FORD HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	230269
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	BEAUMONT HOSPITAL, TROY
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y