Individual Professional Information |
|
NPI
|
1982852166
|
|
Unique healthcare provider (clinician) ID assigned by NPPES
|
|
PECOS UID
|
1456507474
|
|
Unique individual clinician ID assigned by PECOS
|
|
Professional Enrollment ID
|
I20120807000836
|
|
Unique ID for the individual professional enrollment that is the source for the data in the observation
|
|
Provider Last Name
|
HUSSAIN
|
|
Individual professional last name
|
|
Provider First Name
|
YESSAR
|
|
Individual professional first name
|
|
Provider Middle Name
|
M
|
|
Individual professional middle name
|
|
Provider Gender
|
M
|
|
The provider's gender if the provider is a person.
|
Hospital(s) Affiliation Information |
|
Hospital Affiliation CCN 1
|
490009
|
|
Medicare CCN of hospital where individual professional provides service 1
|
|
Hospital Affiliation LBN 1
|
UNIVERSITY OF VIRGINIA MEDICAL CENTER
|
|
Legal business name of hospital where individual professional provides service 1
|
|
Hospital Affiliation CCN 2
|
070018
|
|
Medicare CCN of hospital where individual professional provides service 2
|
|
Hospital Affiliation LBN 2
|
GREENWICH HOSPITAL ASSOCIATION -
|
|
Legal business name of hospital where individual professional provides service 2
|
|
Hospital Affiliation CCN 3
|
390049
|
|
Medicare CCN of hospital where individual professional provides service 3
|
|
Hospital Affiliation LBN 3
|
ST LUKE'S HOSPITAL BETHLEHEM
|
|
Legal business name of hospital where individual professional provides service 3
|
|
Hospital Affiliation CCN 4
|
220171
|
|
Medicare CCN of hospital where individual professional provides service 4
|
|
Hospital Affiliation LBN 4
|
LAHEY HOSPITAL & MEDICAL CENTER, BURLINGTON
|
|
Legal business name of hospital where individual professional provides service 4
|
|
Hospital Affiliation CCN 5
|
490107
|
|
Medicare CCN of hospital where individual professional provides service 5
|
|
Hospital Affiliation LBN 5
|
RESTON HOSPITAL CENTER
|
|
Legal business name of hospital where individual professional provides service 5
|
|
Professional Accepts Medicare Assignment
|
Y
|
|
|