Physician Compare National (NPI:1982081543)

HEALTHCARE PROVIDER: LARA ALKHAWALDEH M.D

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

Individual Professional Information
NPI	1982081543
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8820388176
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180822003398
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ALKHAWALDEH
	Individual professional last name
Provider First Name	LARA
	Individual professional first 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	2015
	Individual professional's medical school graduation year
Primary Specialty	HOSPITALIST
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	FAMILY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	FAMILY MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	FRANCISCAN PHYSICIAN NETWORK
	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	3072790682
	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	979
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3500 FRANCISCAN WAY
	Group Practice or individual's line 1 address
City	MICHIGAN CITY
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	463600021
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2198798511
	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	140008
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GOTTLIEB MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	150126
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	FRANCISCAN HEALTH CROWN POINT
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	140276
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	LOYOLA UNIVERSITY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y