Physician Compare National (NPI:1992921779)

HEALTHCARE PROVIDER: RADHA ANDUKURI 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	1992921779
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1850480401
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120816000577
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ANDUKURI
	Individual professional last name
Provider First Name	RADHA
	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	2001
	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	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	PHYSICIANS CLINIC 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	4880506062
	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	395
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	933 E PIERCE ST
	Group Practice or individual's line 1 address
Line 2 Street Address	METHODIST JENNIE EDMUNDSON
	Group Practice or individual's line 2 address
City	COUNCIL BLUFFS
	Group Practice or individual's city
State	IA
	Group Practice or individual's state
Zip Code	515034626
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7123966000
	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	280040
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	THE NEBRASKA METHODIST HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	160047
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	METHODIST JENNIE EDMUNDSON
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	161352
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	CLARINDA REGIONAL HEALTH CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	161374
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	MYRTUE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y