Physician Compare National (NPI:1982786273)

HEALTHCARE PROVIDER: MANOHAR KOLA 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	1982786273
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0648234740
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20041118000234
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KOLA
	Individual professional last name
Provider First Name	MANOHAR
	Individual professional first 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	OTHER
	Individual professional's medical school
Graduation Year	1972
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	PRAIRIE CARDIOVASCULAR CONSULTANTS LTD
	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	3173435880
	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	94
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1800 E LAKE SHORE DR 6TH FLR
	Group Practice or individual's line 1 address
City	DECATUR
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	625213810
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2174226100
	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	140166
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST MARYS HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140135
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	DECATUR MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	141341
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	PANA COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y