Physician Compare National (NPI:1972745586)

HEALTHCARE PROVIDER: BETHANY L HART 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	1972745586
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4082852884
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20191010003061
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HART
	Individual professional last name
Provider First Name	BETHANY
	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	NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ELLIOT PROFESSIONAL SERVICES
	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	6103727920
	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	243
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	ONE ELLIOT WAY
	Group Practice or individual's line 1 address
City	MANCHESTER
	Group Practice or individual's city
State	NH
	Group Practice or individual's state
Zip Code	03103
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6036633630
	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	300012
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ELLIOT HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y