Physician Compare National (NPI:1942491139)

HEALTHCARE PROVIDER: KELLY LYNNE BIRT MD

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

Individual Professional Information
NPI	1942491139
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0840462388
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111005000879
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BIRT
	Individual professional last name
Provider First Name	KELLY
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	27700 HWY 290
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 330
	Group Practice or individual's line 2 address
City	CYPRESS
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	774336767
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450068
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MEMORIAL HERMANN - TEXAS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450035
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ST JOSEPH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y