KHALIL M SUARAY M.D.
NPI 1578567160
Internal Medicine - Cardiovascular Disease in Middletown, NJ
Quality Rating: 80.61 out of 100 score
NPI Status: Active since June 10, 2005
Contact Information
1270 HIGHWAY 35
MIDDLETOWN, NJ
ZIP 07748
Phone: (732) 615-3900
Fax: (732) 615-0185
- Individual
- Male
- Years of Experience 35
- Internal Medicine
- Cardiovascular Disease
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About KHALIL SUARAY
This page provides the complete NPI Profile along with additional information for Khalil Suaray, an internist established in Middletown, New Jersey with a medical specialization in Internal Medicine, focusing in cardiovascular disease and more than 35 years of experience. He graduated from George Washington University School Of Medicine in 1991. The healthcare provider is registered in the NPI registry with number 1578567160 assigned on June 2005. The practitioner's primary taxonomy code is 207RC0000X with license number 25MA06412300 (NJ). The provider is registered as an individual and his NPI record was last updated 7 years ago.
- NPI
- 1578567160
- Provider Name
- KHALIL M SUARAY M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748
- Location Phone
- (732) 615-3900
- Location Fax
- (732) 615-0185
- Mailing Address
- 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748
- Mailing Phone
- (732) 615-3900
- Mailing Fax
- (732) 615-0185
- Medical School Name
- GEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 1991
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-10-2005
- Last Update Date
- 05-14-2018
- Code Navigator
An internist like Khalil Suaray is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Cardiovascular Disease
- Taxonomy Code
- 207RC0000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 25MA06412300
- License State
- NJ
- Taxonomy Description
- An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
Identifier | Type / Code | Identifier State | Identifier Issuer |
---|---|---|---|
000010DE4 | OTHER (01) | NJ | MEDICARE |
7341903 | MEDICAID (05) | NJ |
Medicare Participation & PECOS Enrollment Status
Khalil Suaray is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Khalil Suaray is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 345202974
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20041027000365
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician
Follow-up nursing facility visit per day, typically 15 minutes
Follow-up nursing facility visit per day, typically 25 minutes
Initial nursing facility visit per day, typically 35 minutes
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.
This service was performed 31 times for 31 patientsAn exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.
This service was performed 52 times for 52 patientsAn exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.
This service was performed 31 times for 31 patientsA follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
This service was performed 111 times for 36 patientsA follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
This service was performed 52 times for 22 patientsAn initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
This service was performed 33 times for 29 patientsA routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
This service was performed 574 times for 538 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $35.08 for a new patient copayment and $19.11 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 07748 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $140.34
- Minimum New Patient Price $61.59
- Maximum New Patient Price $185.05
- Average New Patient Copayment $35.08
- Minimum New Patient Copayment $15.39
- Maximum New Patient Copayment $46.26
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $76.45
- Minimum Established Patient Price $20.08
- Maximum Established Patient Price $150.98
- Average Established Patient Copayment $19.11
- Minimum Established Patient Copayment $5.02
- Maximum Established Patient Copayment $37.74
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 80.61, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 80.61 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 75.87
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: N/A
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
Quality Measure | Performance | Number of Patients |
---|---|---|
Colorectal Cancer Screening | 9% | 196 |
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
Diabetes: Medical Attention for Nephropathy | 100% | 31 |
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period | ||
e-Prescribing | 97% | 2845 |
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
Health Information Exchange | 4% | 26 |
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral. | ||
Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet | 100% | 111 |
Percentage of patients 18 years of age and older who were diagnosed with acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCI) in the 12 months prior to the measurement period, or who had an active diagnosis of ischemic vascular disease (IVD) during the measurement period, and who had documentation of use of aspirin or another antiplatelet during the measurement period | ||
Medication Reconciliation | 95% | 821 |
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
Patient-Specific Education | 57% | 319 |
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 93% | 242 |
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
Provide Patient Access | 13% | 319 |
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
Secure Messaging | 0% | 319 |
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
Security Risk Analysis | Yes | N/A |
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
TCPI Participation | Yes | N/A |
Participation in the CMS Transforming Clinical Practice Initiative |
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Khalil Suaray is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
RIVERVIEW MEDICAL CENTER | ONE RIVERVIEW PLAZA RED BANK, NJ 07701 | (732) 741-2700 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 5 | 7 | 8 | 5 | 6 | 7 | 1 | 6 | 0 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 5 | 14 | 8 | 10 | 6 | 14 | 1 | 12 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 5 + 1 + 4 + 8 + 1 + 0 + 6 + 1 + 4 + 1 + 1 + 2 + 24 = 60 | |||||||||
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
0 |
The NPI number 1578567160 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 17 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1679577274 | MARY E PAUELS ANP-C Individual | Nurse Practitioner (Family) | 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748 (732) 615-3900 |
1215908413 | ALFRED D GREISMAN M.D. Individual | Orthopaedic Surgery | 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748 (732) 615-3900 |
1255305686 | DR. RUSSELL A GROSS MD Individual | Internal Medicine | 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748 (732) 615-3900 |
1053465112 | DR. PAUL JOSEPH LUPARELLO M.D. Individual | Internal Medicine | 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748 (732) 615-3900 |
1568592632 | YELENA POTYLITSINA M.D. Individual | Pediatrics | 1270 HIGHWAY 35 SUITE 1 MIDDLETOWN, NJ 07748 (732) 671-1155 |
1780871764 | KIMBERLY PHYSICAL THERAPY INC Organization | Physical Therapist | 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748 (973) 361-6054 |
1790910966 | DELIA DOBRESCU M.D. Individual | Internal Medicine (Clinical Cardiac Electrophysiology) | 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748 (732) 615-3900 |
1710282132 | COLTS NECK SPINE & JOINT CARE LLC Organization | Physical Therapist | 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748 (732) 615-9420 |
1467427922 | NANCY MARTINEZ APNC Individual | Nurse Practitioner (Family) | 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748 (732) 615-3900 |
1639463730 | DR. ANTHONY JAMES MORELLI D.O. Individual | Hospitalist | 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748 (732) 615-3900 |
1841716321 | CARDIOEP LLC Organization | Internal Medicine (Cardiovascular Disease) | 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748 (732) 615-3900 |
1871597476 | MEGHAN E CLEMENTE ANP-C Individual | Nurse Practitioner (Adult Health) | 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748 (732) 615-3900 |
1164425435 | JOSEPH CLEMENTE M.D. Individual | Internal Medicine (Cardiovascular Disease) | 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748 (732) 615-3900 |
1730178054 | JULIA B RITSAN D.O. Individual | Family Medicine | 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748 (732) 615-3900 |
1295261568 | MEDICAL HEALTH CENTER OF MIDDLETOWN, INC Organization | Family Medicine | 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748 (732) 615-3900 |
1720083116 | MEDICAL HEALTH CENTER, P.A. Organization | Internal Medicine (Cardiovascular Disease) | 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748 (732) 615-3900 |
1356365167 | DR. ANTHONY JOSEPH RICCA MD Individual | Internal Medicine | 1270 HIGHWAY 35 MIDDLETOWN, NJ 07748 (732) 615-3900 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1578567160, enumerated in the NPI registry as an "individual" on June 10, 2005
The provider is located at 1270 Highway 35 Middletown, Nj 07748 and the phone number is (732) 615-3900
The provider's speciality is Internal Medicine with taxonomy code 207RC0000X with a focus in Cardiovascular Disease
The provider has more than 35 years of experience. He graduated from George Washington University School Of Medicine in 1991.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $140.34 with an average copayment of $35.08 for new patient appointments. Established patients should expect a typical charge of $76.45 and an average copayment of 19.11. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician, Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician, Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician, Follow-up nursing facility visit per day, typically 15 minutes, Follow-up nursing facility visit per day, typically 25 minutes, Initial nursing facility visit per day, typically 35 minutes and Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only.
The practitioner is affiliated to the following hospital(s): RIVERVIEW MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on June 10, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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