Download:
pdf |
pdf2015 CMS MA Provider HSD Table
SSA State/County
Code
Name of Physician or
National Provider
Mid-Level Practitioner Identifier (NPI) Number
Specialty
Specialty Code
Contract Type
Provider Street
Address
Provider City
Provider State
Provider Zip Code
Provider Previously
Listed? (Y or N)
If PCP, Accepts New
Patients? (Y or N)
Name of Medical
Group Affiliation or
"DC"
Employment Status
Uses CMS MA Contract
Amendment (Y or N)
| File Type | application/pdf |
| File Title | HSD Table Templates |
| Author | CGI Federal |
| File Modified | 2013-09-20 |
| File Created | 2013-09-20 |