Physician Compare National (NPI:1962582718)

HEALTHCARE PROVIDER: GREGORY J BOMBASSEI 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	1962582718
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2961438502
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050714000466
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BOMBASSEI
	Individual professional last name
Provider First Name	GREGORY
	Individual professional first name
Provider Middle Name	J
	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	UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	ENDOCRINOLOGY
	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
Line 1 Street Address	40 DALE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 202
	Group Practice or individual's line 2 address
City	AVON
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	060013692
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	070011
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CHARLOTTE HUNGERFORD HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	070036
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	JOHN DEMPSEY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	070004
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SHARON HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	070033
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	DANBURY HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y