Physician Compare National (NPI:1952730160)

HEALTHCARE PROVIDER: MEREDITH A CHIDSEY PA-C

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

Individual Professional Information
NPI	1952730160
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1052540184
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140212000551
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHIDSEY
	Individual professional last name
Provider First Name	MEREDITH
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	PHYSICIAN ASSISTANT
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ADAMS STREET DERMATOLOGY ASSOC, PC
	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	0042397374
	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	4
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	36 ADAMS ST
	Group Practice or individual's line 1 address
City	QUINCY
	Group Practice or individual's city
State	MA
	Group Practice or individual's state
Zip Code	021692002
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6177739805
	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	220060
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y