Physician Compare National (NPI:1932631652)

HEALTHCARE PROVIDER: YOUSEF MONZER MAITA DO

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

Individual Professional Information
NPI	1932631652
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8628490893
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200616001428
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MAITA
	Individual professional last name
Provider First Name	YOUSEF
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	ARIZONA COLLEGE OF OSTEOPATHIC MEDICINE MID WESTERN UNIVERSITY
	Individual professional's medical school
Graduation Year	2017
	Individual professional's medical school graduation year
Primary Specialty	HOSPITALIST
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	BANNER HOSPITAL BASED PHYSICIANS ARIZONA 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	3274782487
	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	367
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	37000 N GANTZEL RD
	Group Practice or individual's line 1 address
City	SAN TAN VALLEY
	Group Practice or individual's city
State	AZ
	Group Practice or individual's state
Zip Code	851407303
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4803944000
	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	030088
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BANNER BAYWOOD MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	030105
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BANNER HEART HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y