Physician Compare National (NPI:1962745331)

HEALTHCARE PROVIDER: BOBBY VARGHESE MATHEW

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

Individual Professional Information
NPI	1962745331
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9638397136
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200817000229
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MATHEW
	Individual professional last name
Provider First Name	BOBBY
	Individual professional first name
Provider Middle Name	VARGHESE
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	CRITICAL CARE (INTENSIVISTS)
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PULMONARY DISEASE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PULMONARY DISEASE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	GREATER BALTIMORE MEDICAL CENTER, INC
	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	1759276975
	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	294
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	6565 N CHARLES ST
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	BALTIMORE
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	212045805
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y