Physician Compare National (NPI:1992975940)

HEALTHCARE PROVIDER: DANA FATHY 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	1992975940
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6002989100
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080723000327
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FATHY
	Individual professional last name
Provider First Name	DANA
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2003
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ASSOCIATION OF UNIVERSITY RADIOLOGISTS, PC
	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	0749269785
	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	47
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1990 HOLTON AVE E
	Group Practice or individual's line 1 address
City	BIG STONE GAP
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	242193350
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2765233111
	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	440015
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	UNIVERSITY OF TN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	440030
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MORRISTOWN HAMBLEN HOSPITAL ASSOCIATION
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	440050
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	TAKOMA REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	490114
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	WELLMONT LONESOME PINE HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y