INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('300520570', 'ELTMH0489', 'ELTMH0489', 'TXHOUSTD', 'TMH Physician Associates', 'Min', '', 'Kim', 'MD', 'Thoracic Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415151', '7137906470', '6550 Fannin Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415151', '7137906470', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1558689661', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0140', 'ELTMH0140', 'TXHOUSTD', 'TMH Physician Associates', 'Tayma', '', 'Shaya', 'MD', 'Family Practice', '', '', NULL, 'O', '16605 Southwest Fwy Ste 400', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2812750800', '2812750801', '16605 Southwest Fwy Ste 400', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2812750800', '2812750801', 'TMHPHOPCP', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1568411080', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.5909, -95.6296, NULL, NULL),
('300520570', 'ELTMH0174', 'ELTMH0174', 'TXHOUSTD', 'TMH Physician Associates', 'Kourosh', '', 'Jafarnia', 'MD', 'Hand Surgery', '', '', NULL, 'O', '13802 Centerfield Dr Ste 300', 'Houston', 'Harris', 'TX', '77070', '2817370999', '2817370926', '13802 Centerfield Dr Ste 300', 'Houston', 'Harris', 'TX', '77070', '2817370999', '2817370926', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1568443562', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.9694, -95.5506, NULL, NULL),
('300520570', 'ELTMH0012', 'ELTMH0012', 'TXHOUSTD', '', 'Elizabeth', '', 'Gigliotti', 'ACNP', 'Acute Care Nurse Practitioner', '', '', NULL, 'O', '6565 Fannin St Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', '6565 Fannin St Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568696482', 0, 'Y', 0, '2013-04-11', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('571201170', 'ELTMH0404', 'ELTMH0404', 'TXHOUSTD', '', 'Jenny', '', 'Lai', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '6565 Fannin St Ste 1878', 'Houston', 'Harris', 'TX', '77030', '7134415189', '7137906604', '6565 Fannin St Ste 1878', 'Houston', 'Harris', 'TX', '77030', '7134415189', '7137906604', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-05-19', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1578507182', 0, 'N', 0, '2013-05-20', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('300520570', 'ELTMH0072', 'ELTMH0072', 'TXHOUSTD', 'TMH Physician Associates', 'Craig', '', 'Pratt', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '6550 Fannin St Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', '6550 Fannin Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1578593877', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0124', 'ELTMH0124', 'TXHOUSTD', 'TMH Physician Associates', 'Laura', '', 'Lessard', 'FNP', 'Family Practice', '', '', NULL, 'O', '6550 Fannin St Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', '6550 Fannin Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', 'TMHPHOPCP', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1578643979', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0241', 'ELTMH0241', 'TXHOUSTD', 'TMH Physician Associates', 'Janice', '', 'Zimmerman', 'MD', 'Hospitalist', '', '', NULL, 'O', '6565 Fannin St Ste F270', 'Houston', 'Harris', 'TX', '77030', '7134413020', '7137902727', '6565 Fannin Ste F270', 'Houston', 'Harris', 'TX', '77030', '7134413020', '7137902727', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1578652947', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('300520570', 'ELTMH0242', 'ELTMH0242', 'TXHOUSTD', 'TMH Physician Associates', 'Janice', '', 'Zimmerman', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415129', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415129', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1578652947', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('571201170', 'ELTMH0291', 'ELTMH0291', 'TXHOUSTD', 'TMH Physician Organization', 'Danielle', '', 'Antosh', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '6560 Fannin St Ste 2100', 'Houston', 'Harris', 'TX', '77030', '7134415800', '7137970661', '6560 Fannin St Ste 2100', 'Houston', 'Harris', 'TX', '77030', '7134415800', '7137970661', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1578711495', 0, 'N', 0, '2013-07-03', NULL, NULL, 29.7109, -95.4, NULL, NULL),
('571201170', 'ELTMH0407', 'ELTMH0407', 'TXHOUSTD', 'TMH Physician Organization', 'Joan', '', 'Appel', 'PAC', 'Physician Assistant Certified', '', '', NULL, 'O', '6560 Fannin St Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134413780', '7137937271', '6560 Fannin Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134413780', '7137937271', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1578772232', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4, NULL, NULL),
('300520570', 'ELTMH0327', 'ELTMH0327', 'TXHOUSTD', 'TMH Physician Associates', 'Pedro', '', 'Cosculluela', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 2600', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137902043', '6550 Fannin Ste 2600', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137902043', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1588693386', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0177', 'ELTMH0177', 'TXHOUSTD', 'TMH Physician Associates', 'Lawrence', '', 'Rice', 'MD', 'Hematology', '', '', NULL, 'O', '6550 Fannin St Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', '6550 Fannin Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1588758510', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('371520288', 'ELTMH0363', 'ELTMH0363', 'TXHOUSTD', 'Methodist Pathology Associates', 'Philip', '', 'Cagle', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', NULL, 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', '', '', NULL, 'TMHPHOPATH', '0.00', '0.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', '', '', '', 'HCFA|UB|', '1598713059', 0, 'Y', 0, '2014-04-25', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0223', 'ELTMH0223', 'TXHOUSTD', 'TMH Physician Associates', 'Raul', '', 'Sanchez Leon', 'MD', 'Hospitalist', '', '', NULL, 'O', '6565 Fannin St Ste F270', 'Houston', 'Harris', 'TX', '77030', '7134413020', '7137904207', '6565 Fannin Ste F270', 'Houston', 'Harris', 'TX', '77030', '7134413020', '7137904207', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598758476', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('300520570', 'ELTMH0224', 'ELTMH0224', 'TXHOUSTD', 'TMH Physician Associates', 'Raul', '', 'Sanchez Leon', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598758476', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0005', 'ELTMH0005', 'TXHOUSTD', 'TMH Physician Associates', 'Patricia', '', 'Brenza', 'ACNP', 'Acute Care Nurse Practitioner', '', '', NULL, 'O', '6565 Fannin St Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', '6565 Fannin Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598780173', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('571201170', 'ELTMH0036', 'ELTMH0036', 'TXHOUSTD', 'TMH Physician Organization', 'Mechelle', '', 'Williams', 'ACNP', 'Acute Care Nurse Practitioner', '', '', NULL, 'O', '6565 Fannin St Ste DB1 077', 'Houston', 'Harris', 'TX', '77030', '7134414800', '7134414493', '6565 Fannin St Ste DB1 077', 'Houston', 'Harris', 'TX', '77030', '7134414800', '7134414493', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598986150', 0, 'Y', 0, '2013-09-10', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('571201170', 'ELTMH0038', 'ELTMH0038', 'TXHOUSTD', 'TMH Physician Organization', 'Mechelle', '', 'Williams', 'ACNP', 'Acute Care Nurse Practitioner', '', '', NULL, 'B', 'PO Box 4655', 'Houston', 'Harris', 'TX', '77210', '7134414800', NULL, 'PO Box 4655', 'Houston', 'Harris', 'TX', '77210', '7134414800', '          ', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598986150', 0, 'Y', 0, '2013-09-10', NULL, NULL, 0, 0, NULL, NULL),
('134298938', 'ELTMH0417', 'ELTMH0417', 'TXHOUSTD', 'Carlos Flores PAC', 'Carlos', '', 'Flores', 'PAC', 'Physician Assistant Certified', '', '', NULL, 'O', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137902085', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137902085', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2014-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609856129', 0, 'Y', 0, '2014-02-13', NULL, NULL, 29.7109, -95.4, NULL, NULL),
('300520570', 'ELTMH0497', 'ELTMH0497', 'TXHOUSTD', 'TMH Physician Associates', 'Timothy', '', 'Boone', 'MD', 'Urology', '', '', NULL, 'O', '6560 Fannin St Ste 2100', 'Houston', 'Harris', 'TX', '77030', '7134416455', '7134416463', '6560 Fannin Ste 2100', 'Houston', 'Harris', 'TX', '77030', '7134416455', '7134416463', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1609965896', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4002, NULL, NULL),
('300520570', 'ELTMH0025', 'ELTMH0025', 'TXHOUSTD', 'TMH Physician Associates', 'Corey', '', 'Meisenbach', 'ACNP', 'Acute Care Nurse Practitioner', '', '', NULL, 'O', '6550 Fannin St Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415153', '7137906470', '6550 Fannin Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415153', '7137906470', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619040367', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0076', 'ELTMH0076', 'TXHOUSTD', 'TMH Physician Associates', 'Kesavan', '', 'Shan', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '16651 Southwest Fwy Ste 450', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2812750330', '2812750331', '16651 Southwest Fwy Ste 450', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2812750330', '2812750331', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1619080843', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.5895, -95.6315, NULL, NULL),
('571201170', 'ELTMH0483', 'ELTMH0483', 'TXHOUSTD', 'TMH Physician Organization', 'Amit', '', 'Verma', 'MD', 'Sleep Medicine', '', '', NULL, 'O', '6560 Fannin St Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134413970', '7137932270', '6560 Fannin Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134413970', '7137932270', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619958873', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4, NULL, NULL),
('300520570', 'ELTMH0280', 'ELTMH0280', 'TXHOUSTD', 'TMH Physician Associates', 'Larry', '', 'Tran', 'MD', 'Neurology', '', '', NULL, 'O', '16659 Southwest Fwy Ste 131', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2814946387', '2814946410', '16659 Southwest Fwy Ste 131', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2814946387', '2814946410', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1629259510', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.5881, -95.631, NULL, NULL),
('300520570', 'ELTMH0512', 'ELTMH0512', 'TXHOUSTD', 'TMH Physician Associates', 'Jacobo', '', 'Nurko', 'MD', 'Vascular Surgery', '', '', NULL, 'O', '4301 Garth Rd Ste 212', 'Baytown', 'Harris', 'TX', '77521', '8325566625', '8325566650', '4301 Garth Rd Ste 212', 'Baytown', 'Harris', 'TX', '77521', '8325566625', '8325566650', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1629262621', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7677, -94.9796, NULL, NULL),
('300520570', 'ELTMH0114', 'ELTMH0114', 'TXHOUSTD', 'TMH Physician Associates', 'Tiffany', '', 'Burns', 'MD', 'Family Practice', '', '', NULL, 'O', '18220 Tomball Pkwy Ste 390', 'Houston', 'Harris', 'TX', '77070', '2817370899', '2817370892', '18220 Tomball Pkwy Ste 390', 'Houston', 'Harris', 'TX', '77070', '2817370899', '2817370892', 'TMHPHOPCP', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Willowbrook Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1629289897', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.966, -95.5513, NULL, NULL),
('300520570', 'ELTMH0337', 'ELTMH0337', 'TXHOUSTD', 'TMH Physician Associates', 'Mark', '', 'Maffet', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1639259039', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.6043, -95.634, NULL, NULL),
('300520570', 'ELTMH0506', 'ELTMH0506', 'TXHOUSTD', 'TMH Physician Associates', 'Jean', '', 'Bismuth', 'MD', 'Vascular Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 1401', 'Houston', 'Harris', 'TX', '77030', '7134415200', '7134417428', '6550 Fannin Ste 1401', 'Houston', 'Harris', 'TX', '77030', '7134415200', '7134417428', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1639330053', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0078', 'ELTMH0078', 'TXHOUSTD', 'TMH Physician Associates', 'Barry', '', 'Trachtenberg', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '6550 Fannin St Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', '6550 Fannin Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1639331473', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0482', 'ELTMH0482', 'TXHOUSTD', 'TMH Physician Associates', 'Jovan', '', 'Popovich', 'MD', 'Rheumatology', '', '', NULL, 'O', '6550 Fannin St Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', '6550 Fannin Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1649206822', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0350', 'ELTMH0350', 'TXHOUSTD', 'TMH Physician Associates', 'Bradley', '', 'Weiner', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 2600', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137902141', '6550 Fannin Ste 2600', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137902141', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1649234642', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0165', 'ELTMH0165', 'TXHOUSTD', 'TMH Physician Associates', 'Patrick', '', 'Reardon', 'MD', 'General Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 2435', 'Houston', 'Harris', 'TX', '77030', '7137903140', '7137903235', '6550 Fannin Ste 2435', 'Houston', 'Harris', 'TX', '77030', '7137903140', '7137903235', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1649270265', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0504', 'ELTMH0504', 'TXHOUSTD', 'TMH Physician Associates', 'David', '', 'Mobley', 'MD', 'Urology', '', '', NULL, 'O', '18400 Katy Fwy Ste 350', 'Houston', 'Harris', 'TX', '77094', '8325228300', '8325228301', '18400 Katy Fwy Ste 350', 'Houston', 'Harris', 'TX', '77094', '8325228300', '8325228301', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist West Houston Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1649272170', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7873, -95.6961, NULL, NULL),
('300520570', 'ELTMH0511', 'ELTMH0511', 'TXHOUSTD', 'TMH Physician Associates', 'Alan', '', 'Lumsden', 'MD', 'Vascular Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 1401', 'Houston', 'Harris', 'TX', '77030', '7134415200', '7134417428', '6550 Fannin Ste 1401', 'Houston', 'Harris', 'TX', '77030', '7134415200', '7134417428', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1649350042', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0197', 'ELTMH0197', 'TXHOUSTD', 'TMH Physician Associates', 'John', '', 'Fetter', 'MD', 'Hospitalist', '', '', NULL, 'O', '6565 Fannin St Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', '6565 Fannin Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1659303287', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('300520570', 'ELTMH0198', 'ELTMH0198', 'TXHOUSTD', 'TMH Physician Associates', 'John', '', 'Fetter', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1659303287', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('412152284', 'ELTMH0285', 'ELTMH0285', 'TXHOUSTD', 'TMH Physician Organization', 'Robert', '', 'Grossman', 'MD', 'Neurosurgery', '', '', NULL, 'O', '6560 Fannin St Ste 900', 'Houston', 'Harris', 'TX', '77030', '7134413800', '7137931015', '6560 Fannin St Ste 900', 'Houston', 'Harris', 'TX', '77030', '7134413800', '7137931015', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2014-01-01', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1659306827', 0, 'N', 0, '2013-11-13', NULL, NULL, 29.7109, -95.4002, NULL, NULL),
('300520570', 'ELTMH0118', 'ELTMH0118', 'TXHOUSTD', 'TMH Physician Associates', 'Jennifer', '', 'Diamond', 'MD', 'Family Practice', '', '', NULL, 'O', '16605 Southwest Fwy Ste 400', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2812750800', '2812750801', '16605 Southwest Fwy Ste 400', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2812750800', '2812750801', 'TMHPHOPCP', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1659341717', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.5909, -95.6296, NULL, NULL),
('300520570', 'ELTMH0064', 'ELTMH0064', 'TXHOUSTD', 'TMH Physician Associates', 'Stephen', '', 'Little', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '6550 Fannin St Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7134412643', '6550 Fannin Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7134412643', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1659412336', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0148', 'ELTMH0148', 'TXHOUSTD', 'TMH Physician Associates', 'Emad', '', 'Asham', 'MD', 'General Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', '6550 Fannin St Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1659483287', 0, 'N', 0, '2013-05-30', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0233', 'ELTMH0233', 'TXHOUSTD', 'TMH Physician Associates', 'Divina', '', 'Tuazon', 'MD', 'Hospitalist', '', '', NULL, 'O', '6565 Fannin St Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', '6565 Fannin Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1669457826', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('300520570', 'ELTMH0234', 'ELTMH0234', 'TXHOUSTD', 'TMH Physician Associates', 'Divina', '', 'Tuazon', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1669457826', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0260', 'ELTMH0260', 'TXHOUSTD', 'TMH Physician Associates', 'Christopher', '', 'Robben', 'MD', 'Internal Medicine', '', '', NULL, 'O', '6560 Fannin St Ste 1950', 'Houston', 'Harris', 'TX', '77030', '7134414280', '7137902860', '6560 Fannin Ste 1950', 'Houston', 'Harris', 'TX', '77030', '7134414280', '7137902860', 'TMHPHOPCP', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1669458337', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4002, NULL, NULL),
('300520570', 'ELTMH0430', 'ELTMH0430', 'TXHOUSTD', 'TMH Physician Associates', 'Uy', '', 'Ngo', 'PAC', 'Physician Assistant Certified', '', '', NULL, 'O', '6550 Fannin St Ste 1401', 'Houston', 'Harris', 'TX', '77030', '7134415200', '7137970613', '6550 Fannin Ste 1401', 'Houston', 'Harris', 'TX', '77030', '7134415200', '7137970613', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669552071', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0348', 'ELTMH0348', 'TXHOUSTD', 'TMH Physician Associates', 'Ray', '', 'Valdez', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1669586848', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.6043, -95.634, NULL, NULL),
('571201170', 'ELTMH0278', 'ELTMH0278', 'TXHOUSTD', 'TMH Physician Organization', 'Bryan', '', 'Spann', 'DO', 'Neurology', '', '', NULL, 'O', '6560 Fannin St Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134411150', '7137904990', '6560 Fannin Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134411150', '7137904990', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1679500912', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4, NULL, NULL),
('571201170', 'ELTMH0471', 'ELTMH0471', 'TXHOUSTD', 'TMH Physician Organization', 'Edward', '', 'Butler', 'MD', 'Radiation Oncology', '', '', NULL, 'O', '6565 Fannin St Ste AX 121B', 'Houston', 'Harris', 'TX', '77030', '7134414800', '7137931300', '6565 Fannin Ste AX 121B', 'Houston', 'Harris', 'TX', '77030', '7134414800', '7137931300', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1679565972', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7108, -95.3999, NULL, NULL),
('571201170', 'ELTMH0472', 'ELTMH0472', 'TXHOUSTD', 'TMH Physician Organization', 'Edward', '', 'Butler', 'MD', 'Radiation Oncology', '', '', NULL, 'B', 'PO Box 4655', 'Houston', 'Harris', 'TX', '77210', '7134414347', NULL, 'PO Box 4655', 'Houston', 'Harris', 'TX', '77210', '7134414347', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1679565972', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('571201170', 'ELTMH0303', 'ELTMH0303', 'TXHOUSTD', 'TMH Physician Organization', 'Julia', '', 'Romero', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '18220 Tomball Pkwy Ste 260', 'Houston', 'Harris', 'TX', '77070', '2818904448', '2818904237', '18220 Tomball Pkwy Ste 260', 'Houston', 'Harris', 'TX', '77070', '2818904448', '2818904237', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', 'Houston Methodist Willowbrook Hospital', NULL, NULL, 'HCFA|UB|', '1689731697', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.9641, -95.5508, NULL, NULL),
('300520570', 'ELTMH0481', 'ELTMH0481', 'TXHOUSTD', 'TMH Physician Associates', 'Lina', '', 'Ching', 'MD', 'Rheumatology', '', '', NULL, 'O', '6550 Fannin St Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', '6550 Fannin Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689848996', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0168', 'ELTMH0168', 'TXHOUSTD', 'TMH Physician Associates', 'Nabil', '', 'Tariq', 'MD', 'General Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', '6550 Fannin Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1689881740', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0169', 'ELTMH0169', 'TXHOUSTD', 'TMH Physician Associates', 'Nabil', '', 'Tariq', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415125', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415125', '', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1689881740', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('412152284', 'ELTMH0459', 'ELTMH0459', 'TXHOUSTD', 'TMH Physician Organization', 'Sherry', '', 'Grogan', 'PMHNP', 'Psychiatry', '', '', NULL, 'O', '6560 Fannin St Ste 944', 'Houston', 'Harris', 'TX', '77030', '7134413800', '7137931015', '6560 Fannin St Ste 944', 'Houston', 'Harris', 'TX', '77030', '7134413800', '7137931015', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2014-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1689952012', 0, 'Y', 0, '2013-11-13', NULL, NULL, 29.7109, -95.4002, NULL, NULL),
('300520570', 'ELTMH0498', 'ELTMH0498', 'TXHOUSTD', 'TMH Physician Associates', 'Wesley', '', 'Ekeruo', 'MD', 'Urology', '', '', NULL, 'O', '18400 Katy Fwy Ste 350', 'Houston', 'Harris', 'TX', '77094', '7134416455', '7134416463', '18400 Katy Fwy Ste 350', 'Houston', 'Harris', 'TX', '77094', '7134416455', '7134416463', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist West Houston Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689991408', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7873, -95.6961, NULL, NULL),
('300520570', 'ELTMH0117', 'ELTMH0117', 'TXHOUSTD', 'TMH Physician Associates', 'Ana', '', 'Corteguera', 'DO', 'Family Practice', '', '', NULL, 'O', '16605 Southwest Fwy Ste 400', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2812750800', '2812750801', '16605 Southwest Fwy Ste 400', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2812750800', '2812750801', 'TMHPHOPCP', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1699700765', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.5909, -95.6296, NULL, NULL),
('300520570', 'ELTMH0465', 'ELTMH0465', 'TXHOUSTD', 'TMH Physician Associates', 'Thomas', '', 'Kaleekal', 'MD', 'Pulmonary', '', '', NULL, 'O', '6550 Fannin St Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', '6550 Fannin Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1699765420', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('371520288', 'ELTMH0391', 'ELTMH0391', 'TXHOUSTD', 'Methodist Pathology Associates', 'Andreana', '', 'Rivera', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', NULL, 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', '', '', NULL, 'TMHPHOPATH', '0.00', '0.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1699909846', 0, 'Y', 0, '2013-04-23', NULL, NULL, 0, 0, NULL, NULL),
('134298938', 'ELTMH0451', 'ELTMH0451', 'TXHOUSTD', 'Anthony Echo MD', 'Anthony', '', 'Echo', 'MD', 'Plastic Surgery', '', '', NULL, 'O', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137998428', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137998428', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2014-03-31', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', '', 'HCFA|UB|', '1700027745', 0, 'N', 0, '2014-02-13', NULL, NULL, 29.7109, -95.4, NULL, NULL),
('571201170', 'ELTMH0293', 'ELTMH0293', 'TXHOUSTD', 'TMH Physician Organization', 'Gizelle', '', 'Brooks Carter', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1601 St Joseph Pkwy', 'Houston', 'Harris', 'TX', '77003', '7137577406', '7136577191', '1601 St Joseph Pkwy', 'Houston', 'Harris', 'TX', '77003', '7137577406', '7136577191', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1710079868', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7471, -95.3651, NULL, NULL),
('412152284', 'ELTMH0289', 'ELTMH0289', 'TXHOUSTD', 'TMH Physician Organization', 'Todd', '', 'Trask', 'MD', 'Neurosurgery', '', '', NULL, 'O', '6560 Fannin St Ste 900', 'Houston', 'Harris', 'TX', '77030', '7134413800', '7137931015', '6560 Fannin St Ste 900', 'Houston', 'Harris', 'TX', '77030', '7134413800', '7137931015', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2014-01-01', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', '', 'HCFA|UB|', '1710905393', 0, 'N', 0, '2013-11-13', NULL, NULL, 29.7109, -95.4002, NULL, NULL),
('300520570', 'ELTMH0195', 'ELTMH0195', 'TXHOUSTD', 'TMH Physician Associates', 'Richard', '', 'Day', 'MD', 'Hospitalist', '', '', NULL, 'O', '6565 Fannin St Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', '6565 Fannin Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710965066', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('300520570', 'ELTMH0196', 'ELTMH0196', 'TXHOUSTD', 'TMH Physician Associates', 'Richard', '', 'Day', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710965066', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('571201170', 'ELTMH0277', 'ELTMH0277', 'TXHOUSTD', 'TMH Physician Organization', 'Ericka', '', 'Simpson', 'MD', 'Neurology', '', '', NULL, 'O', '6560 Fannin St Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134413780', '7137937271', '6560 Fannin Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134413780', '7137937271', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1720018021', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4, NULL, NULL),
('300520570', 'ELTMH0441', 'ELTMH0441', 'TXHOUSTD', 'TMH Physician Associates', 'Monika', '', 'Welborn', 'PAC', 'Physician Assistant Certified', '', '', NULL, 'O', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1720157027', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.6043, -95.634, NULL, NULL),
('300520570', 'ELTMH0442', 'ELTMH0442', 'TXHOUSTD', 'TMH Physician Associates', 'Monika', '', 'Welborn', 'PAC', 'Physician Assistant Certified', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134418691', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134418691', '', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1720157027', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0273', 'ELTMH0273', 'TXHOUSTD', 'TMH Physician Associates', 'Eddie', '', 'Patton', 'MD', 'Neurology', '', '', NULL, 'O', '16659 Southwest Fwy Ste 131', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2814946387', '2814946410', '16659 Southwest Fwy Ste 131', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2814946387', '2814946410', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1720213770', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.5881, -95.631, NULL, NULL),
('300520570', 'ELTMH0155', 'ELTMH0155', 'TXHOUSTD', 'TMH Physician Associates', 'Richard', '', 'Knight', 'MD', 'General Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137931840', '6550 Fannin Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137931840', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1730111345', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0413', 'ELTMH0413', 'TXHOUSTD', 'TMH Physician Associates', 'Tobin', '', 'Bushong', 'PAC', 'Physician Assistant Certified', '', '', NULL, 'O', '6550 Fannin St Ste 2600', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137902057', '6550 Fannin Ste 2600', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137902057', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1730164831', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
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('371520288', 'ELTMH0378', 'ELTMH0378', 'TXHOUSTD', 'Methodist Pathology Associates', 'Tracie', '', 'Koen', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', NULL, 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', '', '', NULL, 'TMHPHOPATH', '0.00', '0.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', '', '', '', 'HCFA|UB|', '1730398652', 0, 'Y', 0, '2014-04-25', NULL, NULL, 0, 0, NULL, NULL),
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('383768845', 'ELTMH0102', 'ELTMH0102', 'TXHOUSTD', 'Methodist Radiology Associates', 'Luz', '', 'Venta', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '6550 Fannin St Ste 749', 'Houston', 'Harris', 'TX', '77030', '7134417465', '7137902996', '6550 Fannin Ste 749', 'Houston', 'Harris', 'TX', '77030', '7134417465', '7137902996', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740270263', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7111, -95.3999, NULL, NULL),
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('300520570', 'ELTMH0236', 'ELTMH0236', 'TXHOUSTD', 'TMH Physician Associates', 'Faisal', '', 'Uddin', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1750541041', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('571201170', 'ELTMH0281', 'ELTMH0281', 'TXHOUSTD', 'TMH Physician Organization', 'Aparajitha', '', 'Verma', 'MD', 'Neurology', '', '', NULL, 'O', '6560 Fannin St Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134413961', '7137937271', '6560 Fannin Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134413961', '7137937271', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1750592408', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('300520570', 'ELTMH0158', 'ELTMH0158', 'TXHOUSTD', 'TMH Physician Associates', 'Sylvia', '', 'Martinez', 'MD', 'General Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', '6550 Fannin Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1760634349', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0159', 'ELTMH0159', 'TXHOUSTD', 'TMH Physician Associates', 'Sylvia', '', 'Martinez', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415125', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415125', '', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1760634349', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('571201170', 'ELTMH0295', 'ELTMH0295', 'TXHOUSTD', 'TMH Physician Organization', 'Kylie', 'Jean', 'Galfione', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '6550 Fannin St Ste 2201', 'Houston', 'Harris', 'TX', '77030', '7137979498', '7137970661', '6550 Fannin St Ste 2201', 'Houston', 'Harris', 'TX', '77030', '7137979498', '7137970661', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'The Womans Hospital of Texas', NULL, NULL, NULL, 'HCFA|UB|', '1760644033', 0, 'N', 0, '2014-03-20', NULL, NULL, 29.7111, -95.3999, NULL, NULL),
('300520570', 'ELTMH0047', 'ELTMH0047', 'TXHOUSTD', 'TMH Physician Associates', 'Loren', '', 'Semones', 'ACNP', 'Adult Nurse Practitioner', '', '', NULL, 'O', '6550 Fannin St Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', '6550 Fannin Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1760693576', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0048', 'ELTMH0048', 'TXHOUSTD', 'TMH Physician Associates', 'Loren', '', 'Semones', 'ACNP', 'Adult Nurse Practitioner', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134411892', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134411892', '', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1760693576', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0084', 'ELTMH0084', 'TXHOUSTD', 'TMH Physician Associates', 'Joseph', '', 'Sucher', 'MD', 'Critical Care', '', '', NULL, 'O', '6550 Fannin St Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', '6550 Fannin Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1770515751', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0085', 'ELTMH0085', 'TXHOUSTD', 'TMH Physician Associates', 'Joseph', '', 'Sucher', 'MD', 'Critical Care', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415125', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415125', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1770515751', 0, 'N', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('371520288', 'ELTMH0400', 'ELTMH0400', 'TXHOUSTD', 'Methodist Pathology Associates', 'Arthur', '', 'Zieske', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', NULL, 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', '', '', NULL, 'TMHPHOPATH', '0.00', '0.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1770519415', 0, 'Y', 0, '2013-04-23', NULL, NULL, 0, 0, NULL, NULL),
('371520288', 'ELTMH0359', 'ELTMH0359', 'TXHOUSTD', 'Methodist Pathology Associates', 'Ashok', '', 'Balsaver', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', NULL, 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', '', '', NULL, 'TMHPHOPATH', '0.00', '0.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', '', '', '', 'HCFA|UB|', '1770541054', 0, 'Y', 0, '2014-04-25', NULL, NULL, 0, 0, NULL, NULL),
('383768845', 'ELTMH0104', 'ELTMH0104', 'TXHOUSTD', 'Methodist Radiology Associates', 'Lewis', '', 'Ware', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '6550 Fannin St Ste 749', 'Houston', 'Harris', 'TX', '77030', '7134417465', '7137902996', '6550 Fannin Ste 749', 'Houston', 'Harris', 'TX', '77030', '7134417465', '7137902996', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1770541559', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7111, -95.3999, NULL, NULL),
('383768845', 'ELTMH0105', 'ELTMH0105', 'TXHOUSTD', 'Methodist Radiology Associates', 'Lewis', '', 'Ware', 'MD', 'Diagnostic Radiology', '', '', NULL, 'B', 'PO Box 4109', 'Houston', 'Harris', 'TX', '77210', '2813597788', NULL, 'PO Box 4109', 'Houston', 'Harris', 'TX', '77210', '2813597788', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1770541559', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0183', 'ELTMH0183', 'TXHOUSTD', 'TMH Physician Associates', 'Elie', '', 'Azzi', 'MD', 'Hospitalist', '', '', NULL, 'O', '6565 Fannin St Ste F270', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', '6565 Fannin Ste F270', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1770548786', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('300520570', 'ELTMH0184', 'ELTMH0184', 'TXHOUSTD', 'TMH Physician Associates', 'Elie', '', 'Azzi', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1770548786', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0347', 'ELTMH0347', 'TXHOUSTD', 'TMH Physician Associates', 'Christopher', '', 'Smith', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', 'Houston Methodist Sugar Land Hospital', NULL, NULL, 'HCFA|UB|', '1770585226', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.6043, -95.634, NULL, NULL),
('300520570', 'ELTMH0215', 'ELTMH0215', 'TXHOUSTD', 'TMH Physician Associates', 'Ghassan', '', 'Noureddine', 'MD', 'Hospitalist', '', '', NULL, 'O', '6565 Fannin St Ste F270', 'Houston', 'Harris', 'TX', '77030', '7134413020', '7137904207', '6565 Fannin Ste F270', 'Houston', 'Harris', 'TX', '77030', '7134413020', '7137904207', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1770596736', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('300520570', 'ELTMH0216', 'ELTMH0216', 'TXHOUSTD', 'TMH Physician Associates', 'Ghassan', '', 'Noureddine', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415129', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415129', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1770596736', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0332', 'ELTMH0332', 'TXHOUSTD', 'TMH Physician Associates', 'HoSun', '', 'Hwang', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '13802 Centerfield Dr Ste 300', 'Houston', 'Harris', 'TX', '77070', '2817370999', '2817370926', '13802 Centerfield Ste 300', 'Houston', 'Harris', 'TX', '77070', '2817370999', '2817370926', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1770624793', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.9694, -95.5506, NULL, NULL),
('300520570', 'ELTMH0464', 'ELTMH0464', 'TXHOUSTD', 'TMH Physician Associates', 'Soma', '', 'Jyothula', 'MD', 'Pulmonary', '', '', NULL, 'O', '6550 Fannin St Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', '6550 Fannin Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1770669624', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('371520288', 'ELTMH0365', 'ELTMH0365', 'TXHOUSTD', 'Methodist Pathology Associates', 'Wayne', '', 'Chandler', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', NULL, 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', '', '', NULL, 'TMHPHOPATH', '0.00', '0.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', '', '', '', 'HCFA|UB|', '1770673634', 0, 'Y', 0, '2014-04-25', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0317', 'ELTMH0317', 'TXHOUSTD', 'TMH Physician Associates', 'Allison', '', 'Dublin', 'MD', 'Ophthalmology', '', '', NULL, 'O', '6560 Fannin St Ste 450', 'Houston', 'Harris', 'TX', '77030', '7134418843', '7137931636', '6560 Fannin Ste 450', 'Houston', 'Harris', 'TX', '77030', '7134418843', '7137931636', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1770791725', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4002, NULL, NULL),
('300520570', 'ELTMH0330', 'ELTMH0330', 'TXHOUSTD', 'TMH Physician Associates', 'Travis', '', 'Hanson', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '13802 Centerfield Dr Ste 300', 'Houston', 'Harris', 'TX', '77070', '2817370999', '2817370926', '13802 Centerfield Dr Ste 300', 'Houston', 'Harris', 'TX', '77070', '2817370999', '2817370926', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1780666024', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.9694, -95.5506, NULL, NULL),
('300520570', 'ELTMH0115', 'ELTMH0115', 'TXHOUSTD', 'TMH Physician Associates', 'Mickey', '', 'Bush', 'MD', 'Family Practice', '', '', NULL, 'O', '3424 FM 1092 Ste 220', 'Missouri City', 'Fort Bend', 'TX', '77459', '2812083388', '2812083393', '3424 FM 1092 Ste 220', 'Missouri City', 'Fort Bend', 'TX', '77459', '2812083388', '2812083393', 'TMHPHOPCP', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1780678698', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.5732, -95.5641, NULL, NULL),
('300520570', 'ELTMH0503', 'ELTMH0503', 'TXHOUSTD', 'TMH Physician Associates', 'Brian', '', 'Miles', 'MD', 'Urology', '', '', NULL, 'O', '6560 Fannin St Ste 2100', 'Houston', 'Harris', 'TX', '77030', '7134416455', '7134416463', '6560 Fannin Ste 2100', 'Houston', 'Harris', 'TX', '77030', '7134416455', '7134416463', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1780774752', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4002, NULL, NULL),
('300520570', 'ELTMH0213', 'ELTMH0213', 'TXHOUSTD', 'TMH Physician Associates', 'Julie', '', 'Nguyen', 'MD', 'Hospitalist', '', '', NULL, 'O', '6550 Fannin St Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', '6550 Fannin Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1780811810', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0214', 'ELTMH0214', 'TXHOUSTD', 'TMH Physician Associates', 'Julie', '', 'Nguyen', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415129', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415129', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1780811810', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('371520288', 'ELTMH0384', 'ELTMH0384', 'TXHOUSTD', 'Methodist Pathology Associates', 'Claudia', '', 'Molina', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', NULL, 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', '', '', NULL, 'TMHPHOPATH', '0.00', '0.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780883546', 0, 'Y', 0, '2013-04-23', NULL, NULL, 0, 0, NULL, NULL),
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('300520570', 'ELTMH0505', 'ELTMH0505', 'TXHOUSTD', 'TMH Physician Associates', 'Kenneth', '', 'Yun', 'MD', 'Urology', '', '', NULL, 'O', '18220 Tomball Pkwy Ste 400', 'Houston', 'Harris', 'TX', '77070', '7134416455', '7134416463', '18220 Tomball Pkwy Ste 400', 'Houston', 'Harris', 'TX', '77070', '7134416455', '7134416463', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1780916833', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.966, -95.5513, NULL, NULL),
('300520570', 'ELTMH0109', 'ELTMH0109', 'TXHOUSTD', 'TMH Physician Associates', 'Richard', '', 'Robbins', 'MD', 'Endocrinology', '', '', NULL, 'O', '6550 Fannin St Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7134412727', '6550 Fannin Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7134412727', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1790713428', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0141', 'ELTMH0141', 'TXHOUSTD', 'TMH Physician Associates', 'Mona', '', 'Sheth', 'MD', 'Family Practice', '', '', NULL, 'O', '16605 Southwest Fwy Ste 400', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2812750800', '2812750801', '16605 Southwest Fwy Ste 400', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2812750800', '2812750801', 'TMHPHOPCP', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1790816791', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.5909, -95.6296, NULL, NULL),
('571201170', 'ELTMH0271', 'ELTMH0271', 'TXHOUSTD', 'TMH Physician Organization', 'Eugene', '', 'Lai', 'MD', 'Neurology', '', '', NULL, 'O', '6560 Fannin St Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134411150', '7137904990', '6560 Fannin Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134411150', '7137904990', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1790871002', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4, NULL, NULL),
('300520570', 'ELTMH0245', 'ELTMH0245', 'TXHOUSTD', 'TMH Physician Associates', 'Madiha', '', 'Ashraf', 'MD', 'Infectious Disease', '', '', NULL, 'O', '6550 Fannin St Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', '6550 Fannin Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1790936144', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('412152284', 'ELTMH0460', 'ELTMH0460', 'TXHOUSTD', 'TMH Physician Organization', 'Alric', '', 'Hawkins', 'MD', 'Psychiatry', '', '', NULL, 'O', '6560 Fannin St Ste 900', 'Houston', 'Harris', 'TX', '77030', '7134413800', '7137931015', '6560 Fannin St Ste 900', 'Houston', 'Harris', 'TX', '77030', '7134413800', '7137931015', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2014-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790989283', 0, 'Y', 0, '2013-11-13', NULL, NULL, 29.7109, -95.4002, NULL, NULL),
('300520570', 'ELTMH0201', 'ELTMH0201', 'TXHOUSTD', 'TMH Physician Associates', 'Zoulficar', '', 'Kobeissi', 'MD', 'Hospitalist', '', '', NULL, 'O', '6565 Fannin St Ste F270', 'Houston', 'Harris', 'TX', '77030', '7134413020', '7137904207', '6565 Fannin Ste F270', 'Houston', 'Harris', 'TX', '77030', '7134413020', '7137904207', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801864905', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('300520570', 'ELTMH0202', 'ELTMH0202', 'TXHOUSTD', 'TMH Physician Associates', 'Zoulficar', '', 'Kobeissi', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801864905', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0312', 'ELTMH0312', 'TXHOUSTD', 'TMH Physician Associates', 'Daniel', '', 'Lehane', 'MD', 'Oncology', '', '', NULL, 'O', '6445 Main St Ste OPC 21', 'Houston', 'Harris', 'TX', '77030', '7134419948', '7137931642', '6445 Main St Ste OPC 21', 'Houston', 'Harris', 'TX', '77030', '7134419948', '7137931642', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1801939202', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7123, -95.4002, NULL, NULL),
('300520570', 'ELTMH0310', 'ELTMH0310', 'TXHOUSTD', 'TMH Physician Associates', 'Jorge', '', 'Darcourt', 'MD', 'Oncology', '', '', NULL, 'O', '16659 Southwest Fwy Ste 151', 'Sugar Land', 'Fort Bend', 'TX', '77479', '7134419523', '7137931642', '16659 Southwest Fwy Ste 151', 'Sugar Land', 'Fort Bend', 'TX', '77479', '7134419523', '7137931642', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1811133697', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.5881, -95.631, NULL, NULL),
('300520570', 'ELTMH0040', 'ELTMH0040', 'TXHOUSTD', 'TMH Physician Associates', 'Nancy', '', 'Yarbrough', 'ACNP', 'Acute Care Nurse Practitioner', '', '', NULL, 'O', '6550 Fannin St Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', '6550 Fannin Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811253131', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0041', 'ELTMH0041', 'TXHOUSTD', 'TMH Physician Associates', 'Nancy', '', 'Yarbrough', 'ACNP', 'Acute Care Nurse Practitioner', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415125', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415125', '', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811253131', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('571201170', 'ELTMH0267', 'ELTMH0267', 'TXHOUSTD', 'TMH Physician Organization', 'Stanley', '', 'Fisher', 'MD', 'Neurology', '', '', NULL, 'O', '6560 Fannin St Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134413780', '7137906468', '6560 Fannin St Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134413780', '7137906468', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1811927114', 0, 'N', 0, '2013-03-22', NULL, NULL, 29.7109, -95.4, NULL, NULL),
('300520570', 'ELTMH0329', 'ELTMH0329', 'TXHOUSTD', 'TMH Physician Associates', 'Mark', '', 'Franklin', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '4201 Garth Rd Ste 107', 'Baytown', 'Harris', 'TX', '77521', '2814277400', '2814278750', '4201 Garth Rd Ste 107', 'Baytown', 'Harris', 'TX', '77521', '2814277400', '2814278750', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1811985328', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7677, -94.9796, NULL, NULL),
('300520570', 'ELTMH0077', 'ELTMH0077', 'TXHOUSTD', 'TMH Physician Associates', 'Guillermo', '', 'Torre', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '6550 Fannin St Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', '6550 Fannin Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1821024019', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
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('300520570', 'ELTMH0060', 'ELTMH0060', 'TXHOUSTD', 'TMH Physician Associates', 'Byron', '', 'Ellis', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '7777 Southwest Fwy Ste 420', 'Houston', 'Harris', 'TX', '77074', '7137769500', '7139889153', '7777 Southwest Fwy Ste 420', 'Houston', 'Harris', 'TX', '77074', '7137769500', '7139889153', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1821046780', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.6948, -95.5233, NULL, NULL),
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('300520570', 'ELTMH0331', 'ELTMH0331', 'TXHOUSTD', 'TMH Physician Associates', 'Carl', '', 'Hicks', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1821100827', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.6043, -95.634, NULL, NULL),
('300520570', 'ELTMH0252', 'ELTMH0252', 'TXHOUSTD', 'TMH Physician Associates', 'Michael', '', 'Feltovich', 'MD', 'Internal Medicine', '', '', NULL, 'O', '6550 Fannin St Ste 1101', 'Houston', 'Harris', 'Tx', '77030', '7134410006', '7137902727', '6550 Fannin Ste 1101', 'Houston', 'Harris', 'Tx', '77030', '7134410006', '7137902727', 'TMHPHOPCP', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1821137241', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0205', 'ELTMH0205', 'TXHOUSTD', 'TMH Physician Associates', 'Dana', '', 'Martin', 'MD', 'Hospitalist', '', '', NULL, 'O', '6565 Fannin St Ste F270', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137904207', '6565 Fannin St Ste F270', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137904207', 'TMHPHOHSP', '', '', '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821170200', 0, 'Y', 0, '2013-07-03', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('300520570', 'ELTMH0206', 'ELTMH0206', 'TXHOUSTD', 'TMH Physician Associates', 'Dana', '', 'Martin', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821170200', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0166', 'ELTMH0166', 'TXHOUSTD', 'TMH Physician Associates', 'Ashish', '', 'Saharia', 'MD', 'General Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', '6550 Fannin Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1821241571', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('571201170', 'ELTMH0296', 'ELTMH0296', 'TXHOUSTD', 'TMH Physician Organization', 'Hailey', '', 'Hall', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '6550 Fannin St Ste 2201', 'Houston', 'Harris', 'TX', '77030', '7137979498', '7137970661', '6550 Fannin Ste 2201', 'Houston', 'Harris', 'TX', '77030', '7137979498', '7137970661', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1821293499', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7111, -95.3999, NULL, NULL),
('300520570', 'ELTMH0339', 'ELTMH0339', 'TXHOUSTD', 'TMH Physician Associates', 'Eddie', '', 'Matsu', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1831187889', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.6043, -95.634, NULL, NULL),
('300520570', 'ELTMH0001', 'ELTMH0001', 'TXHOUSTD', 'TMH Physician Associates', 'Prashanth', '', 'Anumandla', 'ACNP', 'Acute Care Nurse Practitioner', '', '', NULL, 'O', '6550 Fannin St Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', '6550 Fannin St Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1831208966', 0, 'Y', 0, '2013-05-30', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('571201170', 'ELTMH0353', 'ELTMH0353', 'TXHOUSTD', 'TMH Physician Organization', 'Pankaj', '', 'Satija', 'MD', 'Pain Management', '', '', NULL, 'O', '6550 Fannin St Ste 489', 'Houston', 'Harris', 'TX', '77030', '7134412889', '7134415764', '6550 Fannin St Ste 489', 'Houston', 'Harris', 'TX', '77030', '7134412889', '7134415764', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1831352616', 0, 'Y', 0, '2014-04-01', NULL, NULL, 29.7111, -95.3999, NULL, NULL),
('300520570', 'ELTMH0121', 'ELTMH0121', 'TXHOUSTD', 'TMH Physician Associates', 'Saundra', '', 'Hendricks', 'FNP', 'Family Practice', '', '', NULL, 'O', '6550 Fannin St Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', '6550 Fannin St Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', 'TMHPHOPCP', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1841255726', 0, 'Y', 0, '2013-03-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('371520288', 'ELTMH0377', 'ELTMH0377', 'TXHOUSTD', 'Methodist Pathology Associates', 'Bisong', '', 'Haupt', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', NULL, 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', '', '', NULL, 'TMHPHOPATH', '0.00', '0.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', '', '', '', 'HCFA|UB|', '1841488202', 0, 'Y', 0, '2014-04-25', NULL, NULL, 0, 0, NULL, NULL),
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('371520288', 'ELTMH0390', 'ELTMH0390', 'TXHOUSTD', 'Methodist Pathology Associates', 'Suzanne', '', 'Powell', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', NULL, 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', '', '', NULL, 'TMHPHOPATH', '0.00', '0.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1851349310', 0, 'Y', 0, '2013-04-23', NULL, NULL, 0, 0, NULL, NULL),
('571201170', 'ELTMH0292', 'ELTMH0292', 'TXHOUSTD', 'TMH Physician Organization', 'Michelle', '', 'Barcio', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '10130 Louetta Rd Ste G', 'Houston', 'Harris', 'TX', '77070', '8326985500', '8326985540', '10130 Louetta Rd Ste G', 'Houston', 'Harris', 'TX', '77070', '8326985500', '8326985540', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Willowbrook Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1851394068', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.9997, -95.563, NULL, NULL),
('300520570', 'ELTMH0420', 'ELTMH0420', 'TXHOUSTD', 'TMH Physician Associates', 'Cheryl', '', 'Hood', 'PAC', 'Physician Assistant Certified', '', '', NULL, 'O', '6550 Fannin St Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', '6550 Fannin Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1851512826', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0052', 'ELTMH0052', 'TXHOUSTD', 'TMH Physician Associates', 'Colin', '', 'Barker', 'MD', 'Cardiology', '', '', NULL, 'O', '6550 Fannin St Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', '6550 Fannin Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1851551238', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0219', 'ELTMH0219', 'TXHOUSTD', 'TMH Physician Associates', 'Iqbal', '', 'Ratnani', 'MD', 'Hospitalist', '', '', NULL, 'O', '6565 Fannin St Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', '6565 Fannin Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1861440190', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('300520570', 'ELTMH0220', 'ELTMH0220', 'TXHOUSTD', 'TMH Physician Associates', 'Iqbal', '', 'Ratnani', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1861440190', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0132', 'ELTMH0132', 'TXHOUSTD', 'TMH Physician Associates', 'Elena', '', 'Ruocco', 'FNP', 'Family Practice', '', '', NULL, 'O', '6560 Fannin St Ste 2100', 'Houston', 'Harris', 'TX', '77030', '7134416455', '7134416463', '6560 Fannin Ste 2100', 'Houston', 'Harris', 'TX', '77030', '7134416455', '7134416463', 'TMHPHOPCP', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1861530008', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4002, NULL, NULL),
('300520570', 'ELTMH0133', 'ELTMH0133', 'TXHOUSTD', 'TMH Physician Associates', 'Elena', '', 'Ruocco', 'FNP', 'Family Practice', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134418691', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134418691', '', 'TMHPHOPCP', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1861530008', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0053', 'ELTMH0053', 'TXHOUSTD', 'TMH Physician Associates', 'Amish', '', 'Dave', 'MD', 'Cardiology', '', '', NULL, 'O', '6550 Fannin St Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', '6550 Fannin Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1861541922', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0058', 'ELTMH0058', 'TXHOUSTD', 'TMH Physician Associates', 'John', '', 'Buergler', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '6550 Fannin St Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', '6550 Fannin Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1871538165', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('371520288', 'ELTMH0383', 'ELTMH0383', 'TXHOUSTD', 'Methodist Pathology Associates', 'Dina', '', 'Mody', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', NULL, 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', '', '', NULL, 'TMHPHOPATH', '0.00', '0.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1871551176', 0, 'Y', 0, '2013-04-23', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0487', 'ELTMH0487', 'TXHOUSTD', 'TMH Physician Associates', 'Brian', '', 'Bruckner', 'MD', 'Thoracic Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 1401', 'Houston', 'Harris', 'TX', '77030', '7134415200', '7134416298', '6550 Fannin Ste 1401', 'Houston', 'Harris', 'TX', '77030', '7134415200', '7134416298', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1871573097', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('412152284', 'ELTMH0272', 'ELTMH0272', 'TXHOUSTD', 'TMH Physician Organization', 'Pamela', '', 'New', 'MD', 'Neurology', '', '', NULL, 'O', '6560 Fannin St Ste 900', 'Houston', 'Harris', 'TX', '77030', '7134413800', '7137931015', '6560 Fannin St Ste 900', 'Houston', 'Harris', 'TX', '77030', '7134413800', '7137931015', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2014-01-01', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', '', 'HCFA|UB|', '1881623718', 0, 'N', 0, '2013-11-13', NULL, NULL, 29.7109, -95.4002, NULL, NULL),
('300520570', 'ELTMH0149', 'ELTMH0149', 'TXHOUSTD', 'TMH Physician Associates', 'Barbara', '', 'Bass', 'MD', 'General Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', '6550 Fannin Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1881632636', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('571201170', 'ELTMH0276', 'ELTMH0276', 'TXHOUSTD', 'TMH Physician Organization', 'David', '', 'Rosenfield', 'MD', 'Neurology', '', '', NULL, 'O', '6560 Fannin St Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134415070', '7137902685', '6560 Fannin Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134415070', '7137902685', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1881675734', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4, NULL, NULL),
('571201170', 'ELTMH0473', 'ELTMH0473', 'TXHOUSTD', 'TMH Physician Organization', 'Arnold', '', 'Paulino', 'MD', 'Radiation Oncology', '', '', NULL, 'O', '6565 Fannin St Ste AX 121B', 'Houston', 'Harris', 'TX', '77030', '7134414800', '7137931300', '6565 Fannin St Ste AX 121B', 'Houston', 'Harris', 'TX', '77030', '7134414800', '7137931300', 'TMHPHOHSP', '', '', '0.00', '0.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1881686152', 0, 'N', 0, '2013-03-22', NULL, NULL, 29.7108, -95.3999, NULL, NULL),
('571201170', 'ELTMH0474', 'ELTMH0474', 'TXHOUSTD', 'TMH Physician Organization', 'Arnold', '', 'Paulino', 'MD', 'Radiation Oncology', '', '', NULL, 'B', 'PO Box 4655', 'Houston', 'Harris', 'TX', '77210', '7134414347', NULL, 'PO Box 4655', 'Houston', 'Harris', 'TX', '77210', '7134414347', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1881686152', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('571201170', 'ELTMH0475', 'ELTMH0475', 'TXHOUSTD', 'TMH Physician Organization', 'Kathleen', '', 'Shadle', 'MD', 'Radiation Oncology', '', '', NULL, 'O', '13802 Centerfield Dr Ste 185', 'Houston', 'Harris', 'TX', '77070', '2814774425', '2814774142', '13802 Centerfield Rd Ste 185', 'Houston', 'Harris', 'TX', '77070', '2814774425', '2814774142', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', 'Houston Methodist Sugar Land Hospital', NULL, NULL, 'HCFA|UB|', '1881686343', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.967, -95.5471, NULL, NULL),
('571201170', 'ELTMH0476', 'ELTMH0476', 'TXHOUSTD', 'TMH Physician Organization', 'Kathleen', '', 'Shadle', 'MD', 'Radiation Oncology', '', '', NULL, 'B', 'PO Box 4655', 'Houston', 'Harris', 'TX', '77210', '7134414347', NULL, 'PO Box 4655', 'Houston', 'Harris', 'TX', '77210', '7134414347', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', 'Houston Methodist Sugar Land Hospital', NULL, NULL, 'HCFA|UB|', '1881686343', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('571201170', 'ELTMH0463', 'ELTMH0463', 'TXHOUSTD', 'TMH Physician Organization', 'Venessa', '', 'Holland', 'MD', 'Pulmonary', '', '', NULL, 'O', '6560 Fannin St Ste 802', 'Houston', 'Harris', 'TX', '77030', '7137992224', '7137904990', '6560 Fannin St Ste 802', 'Houston', 'Harris', 'TX', '77030', '7137992224', '7137904990', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1881774693', 0, 'N', 0, '2013-03-22', NULL, NULL, 29.7109, -95.4, NULL, NULL),
('300520570', 'ELTMH0034', 'ELTMH0034', 'TXHOUSTD', 'TMH Physician Associates', 'Timothy', '', 'Traugott', 'ACNP', 'Acute Care Nurse Practitioner', '', '', NULL, 'O', '6565 Fannin St Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', '6565 Fannin Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881858694', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('300520570', 'ELTMH0035', 'ELTMH0035', 'TXHOUSTD', 'TMH Physician Associates', 'Timothy', '', 'Traugott', 'ACNP', 'Acute Care Nurse Practitioner', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', '', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881858694', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
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('300520570', 'ELTMH0495', 'ELTMH0495', 'TXHOUSTD', 'TMH Physician Associates', 'Dewei', '', 'Ren', 'MD', 'Thoracic Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 1401', 'Houston', 'Harris', 'TX', '77030', '7134415200', '7137970613', '6550 Fannin Ste 1401', 'Houston', 'Harris', 'TX', '77030', '7134415200', '7137970613', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1891022414', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0349', 'ELTMH0349', 'TXHOUSTD', 'TMH Physician Associates', 'Kevin', '', 'Varner', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 2600', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137902042', '6550 Fannin Ste 2600', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137902042', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1891731303', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('571201170', 'ELTMH0266', 'ELTMH0266', 'TXHOUSTD', 'TMH Physician Organization', 'Howard', '', 'Derman', 'MD', 'Neurology', '', '', NULL, 'O', '6560 Fannin St Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134413780', '7137937271', '6560 Fannin Ste 802', 'Houston', 'Harris', 'TX', '77030', '7134413780', '7137937271', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1891776712', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4, NULL, NULL),
('371520288', 'ELTMH0368', 'ELTMH0368', 'TXHOUSTD', 'Methodist Pathology Associates', 'James', '', 'Davis', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', NULL, 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', '', '', NULL, 'TMHPHOPATH', '0.00', '0.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', '', '', '', 'HCFA|UB|', '1891908059', 0, 'Y', 0, '2014-04-25', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0484', 'ELTMH0484', 'TXHOUSTD', 'TMH Physician Associates', 'Winfield', '', 'Campbell', 'MD', 'Sports Medicine', '', '', NULL, 'O', '18400 Katy Fwy Ste 520', 'Houston', 'Harris', 'TX', '77094', '8325228280', '8325228281', '18400 Katy Fwy Ste 520', 'Houston', 'Harris', 'TX', '77094', '8325228280', '8325228281', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1891959615', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7873, -95.6961, NULL, NULL),
('300520570', 'ELTMH0510', 'ELTMH0510', 'TXHOUSTD', 'TMH Physician Associates', 'Richard', '', 'Lee', 'MD', 'Vascular Surgery', '', '', NULL, 'O', '13300 Hargrave Rd Ste 390', 'Houston', 'Harris', 'TX', '77070', '2817372918', '2817372919', '13300 Hargrave Rd Ste 390', 'Houston', 'Harris', 'TX', '77070', '2817372918', '2817372919', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1902810112', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.9679, -95.5517, NULL, NULL),
('300520570', 'ELTMH0351', 'ELTMH0351', 'TXHOUSTD', 'TMH Physician Associates', 'Leland', '', 'Winston', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 2600', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137902057', '6550 Fannin Ste 2600', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137902057', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1902836208', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0434', 'ELTMH0434', 'TXHOUSTD', 'TMH Physician Associates', 'Theresa', '', 'Rand', 'PAC', 'Physician Assistant Certified', '', '', NULL, 'O', '6565 Fannin St Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134412677', '7137906313', '6565 Fannin Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134412677', '7137906313', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1902841919', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7098, -95.3999, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('371520288', 'ELTMH0381', 'ELTMH0381', 'TXHOUSTD', 'Methodist Pathology Associates', 'Christopher', '', 'Leveque', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', NULL, 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', '', '', NULL, 'TMHPHOPATH', '0.00', '0.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1912902248', 0, 'Y', 0, '2013-04-23', NULL, NULL, 0, 0, NULL, NULL),
('412152284', 'ELTMH0288', 'ELTMH0288', 'TXHOUSTD', 'TMH Physician Organization', 'Richard', '', 'Simpson', 'MD', 'Neurosurgery', '', '', NULL, 'O', '6560 Fannin St Ste 900', 'Houston', 'Harris', 'TX', '77030', '7134413800', '7137931015', '6560 Fannin St Ste 900', 'Houston', 'Harris', 'TX', '77030', '7134413800', '7137931015', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2014-01-01', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', '', 'HCFA|UB|', '1912925595', 0, 'N', 0, '2013-11-13', NULL, NULL, 29.7109, -95.4002, NULL, NULL),
('300520570', 'ELTMH0338', 'ELTMH0338', 'TXHOUSTD', 'TMH Physician Associates', 'Kenneth', '', 'Mathis', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 2500', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137902141', '6550 Fannin St Ste 2500', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137902141', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1912940487', 0, 'N', 0, '2013-03-22', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('383768845', 'ELTMH0100', 'ELTMH0100', 'TXHOUSTD', 'Methodist Radiology Associates', 'Correna', '', 'Terrell', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '6550 Fannin St Ste 749', 'Houston', 'Harris', 'TX', '77030', '7134417465', '7137902996', '6550 Fannin Ste 749', 'Houston', 'Harris', 'TX', '77030', '7134417465', '7137902996', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912944307', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7111, -95.3999, NULL, NULL),
('383768845', 'ELTMH0101', 'ELTMH0101', 'TXHOUSTD', 'Methodist Radiology Associates', 'Correna', '', 'Terrell', 'MD', 'Diagnostic Radiology', '', '', NULL, 'B', 'PO Box 4109', 'Houston', 'Harris', 'TX', '77210', '2813597788', NULL, 'PO Box 4109', 'Houston', 'Harris', 'TX', '77210', '2813597788', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912944307', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('571201170', 'ELTMH0294', 'ELTMH0294', 'TXHOUSTD', 'TMH Physician Organization', 'Traci', '', 'DeSplinter', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '18220 Tomball Pkwy Ste 400', 'Houston', 'Harris', 'TX', '77070', '2817371320', '2817371321', '18220 Tomball Pkwy Ste 400', 'Houston', 'Harris', 'TX', '77070', '2817371320', '2817371321', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Willowbrook Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1912956012', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.9641, -95.5508, NULL, NULL),
('300520570', 'ELTMH0062', 'ELTMH0062', 'TXHOUSTD', 'TMH Physician Associates', 'Neal', '', 'Kleiman', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '6550 Fannin St Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', '6550 Fannin Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1922038298', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0334', 'ELTMH0334', 'TXHOUSTD', 'TMH Physician Associates', 'Kaare', '', 'Kolstad', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '6560 Fannin St Ste 410', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137902099', '6560 Fannin Ste 410', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137902099', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1922042373', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4002, NULL, NULL),
('300520570', 'ELTMH0423', 'ELTMH0423', 'TXHOUSTD', 'TMH Physician Associates', 'Gena', '', 'Marshall', 'PAC', 'Physician Assistant Certified', '', '', NULL, 'O', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1922095173', 0, 'Y', 0, '2013-04-11', NULL, NULL, 29.6043, -95.634, NULL, NULL),
('300520570', 'ELTMH0082', 'ELTMH0082', 'TXHOUSTD', 'TMH Physician Associates', 'Shaikh', '', 'Hai', 'MD', 'Critical Care', '', '', NULL, 'O', '6550 Fannin St Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', '6550 Fannin Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1932120144', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0083', 'ELTMH0083', 'TXHOUSTD', 'TMH Physician Associates', 'Shaikh', '', 'Hai', 'MD', 'Critical Care', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415125', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415125', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1932120144', 0, 'N', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0079', 'ELTMH0079', 'TXHOUSTD', 'TMH Physician Associates', 'William', '', 'Winters', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '6550 Fannin St Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', '6550 Fannin Ste 1901', 'Houston', 'Harris', 'TX', '77030', '7134411100', '7137902643', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1932139334', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('134298938', 'ELTMH0453', 'ELTMH0453', 'TXHOUSTD', 'Jeffrey Friedman MD', 'Jeffrey', '', 'Friedman', 'MD', 'Plastic Surgery', '', '', NULL, 'O', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137902087', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137902087', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2014-03-31', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1942235114', 0, 'N', 0, '2014-02-13', NULL, NULL, 29.7109, -95.4, NULL, NULL),
('571201170', 'ELTMH0171', 'ELTMH0171', 'TXHOUSTD', 'TMH Physician Organization', 'Anne', '', 'Alaniz', 'DO', 'Gynecologic Oncology', '', '', NULL, 'O', '18220 Tomball Pkwy Ste 280', 'Houston', 'Harris', 'TX', '77070', '2818904448', '2818904237', '18220 Tomball Pkwy Ste 280', 'Houston', 'Harris', 'TX', '77070', '2818904448', '2818904237', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Willowbrook Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1942239652', 0, 'N', 0, '2013-05-10', NULL, NULL, 29.9641, -95.5508, NULL, NULL),
('134298938', 'ELTMH0450', 'ELTMH0450', 'TXHOUSTD', 'Tue Dinh MD', 'Tue', '', 'Dinh', 'MD', 'Plastic Surgery', '', '', NULL, 'O', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134410714', '7137902086', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134410714', '7137902086', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2014-03-31', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1942246616', 0, 'N', 0, '2014-02-13', NULL, NULL, 29.7109, -95.4, NULL, NULL),
('371520288', 'ELTMH0394', 'ELTMH0394', 'TXHOUSTD', 'Methodist Pathology Associates', 'Steven', '', 'Shen', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', NULL, 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', '', '', NULL, 'TMHPHOPATH', '0.00', '0.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1942258405', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('371520288', 'ELTMH0371', 'ELTMH0371', 'TXHOUSTD', 'Methodist Pathology Associates', 'Lillian', '', 'Gaber', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', NULL, 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', '', '', NULL, 'TMHPHOPATH', '0.00', '0.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', '', '', '', 'HCFA|UB|', '1942465448', 0, 'Y', 0, '2014-04-25', NULL, NULL, 0, 0, NULL, NULL),
('571201170', 'ELTMH0305', 'ELTMH0305', 'TXHOUSTD', 'TMH Physician Organization', 'Priti', '', 'Schachel', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1601 St Joseph Pkwy', 'Houston', 'Harris', 'TX', '77003', '7137577406', '7136577191', '1601 St Joseph Pkwy', 'Houston', 'Harris', 'TX', '77003', '7137577406', '7136577191', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1952307555', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7471, -95.3651, NULL, NULL),
('300520570', 'ELTMH0326', 'ELTMH0326', 'TXHOUSTD', 'TMH Physician Associates', 'Evan', '', 'Collins', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '6560 Fannin St Ste 410', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137902099', '6560 Fannin Ste 410', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137902099', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1952338113', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4002, NULL, NULL),
('300520570', 'ELTMH0486', 'ELTMH0486', 'TXHOUSTD', 'TMH Physician Associates', 'Shanda', '', 'Blackmon', 'MD', 'Thoracic Surgery', '', '', NULL, 'O', '6550 Fannin St Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', '6550 Fannin Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1952347965', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0502', 'ELTMH0502', 'TXHOUSTD', 'TMH Physician Associates', 'Wesley', '', 'Mayer', 'MD', 'Urology', '', '', NULL, 'O', '6560 Fannin St Ste 2100', 'Houston', 'Harris', 'TX', '77030', '7134416455', '7134416463', '6560 Fannin Ste 2100', 'Houston', 'Harris', 'TX', '77030', '7134416455', '7134416463', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1952467367', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4002, NULL, NULL),
('371520288', 'ELTMH0386', 'ELTMH0386', 'TXHOUSTD', 'Methodist Pathology Associates', 'James', '', 'Musser', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', NULL, 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', '', '', NULL, 'TMHPHOPATH', '0.00', '0.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1952514119', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('571201170', 'ELTMH0454', 'ELTMH0454', 'TXHOUSTD', 'TMH Physician Organization', 'Liza', '', 'Kim', 'MD', 'Plastic Surgery', '', '', NULL, 'O', '4201 Garth Rd Ste 201', 'Baytown', 'Harris', 'TX', '77521', '2814208658', '8325566545', '4201 Garth Rd Ste 201', 'Baytown', 'Harris', 'TX', '77521', '2814208658', '8325566545', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, '', '', 'HCFA|UB|', '1952515322', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.7677, -94.9775, NULL, NULL),
('571201170', 'ELTMH0306', 'ELTMH0306', 'TXHOUSTD', 'TMH Physician Organization', 'Latricia', '', 'Thompson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '18220 Tomball Pkwy Ste 260', 'Houston', 'Harris', 'TX', '77070', '2818904448', '2818904237', '18220 Tomball Pkwy Ste 260', 'Houston', 'Harris', 'TX', '77070', '2818904448', '2818904237', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', 'Houston Methodist Willowbrook Hospital', NULL, NULL, 'HCFA|UB|', '1952533168', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.9641, -95.5508, NULL, NULL),
('300520570', 'ELTMH0249', 'ELTMH0249', 'TXHOUSTD', 'TMH Physician Associates', 'Ana', '', 'Blackmon', 'MD', 'Internal Medicine', '', '', NULL, 'O', '6560 Fannin St Ste 1950', 'Houston', 'Harris', 'TX', '77030', '7134414280', '7137902860', '6560 Fannin Ste 1950', 'Houston', 'Harris', 'TX', '77030', '7134414280', '7137902860', 'TMHPHOPCP', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1962402446', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4002, NULL, NULL),
('300520570', 'ELTMH0319', 'ELTMH0319', 'TXHOUSTD', 'TMH Physician Associates', 'Andrew', '', 'Lee', 'MD', 'Ophthalmology', '', '', NULL, 'O', '6560 Fannin St Ste 450', 'Houston', 'Harris', 'TX', '77030', '7134418843', '7137931636', '6560 Fannin Ste 450', 'Houston', 'Harris', 'TX', '77030', '7134418843', '7137931636', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1962403105', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4002, NULL, NULL),
('300520570', 'ELTMH0421', 'ELTMH0421', 'TXHOUSTD', 'TMH Physician Associates', 'Nooreahmed', '', 'Latiff', 'PAC', 'Physician Assistant Certified', '', '', NULL, 'O', '6565 Fannin St Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', '6565 Fannin Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962410647', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('300520570', 'ELTMH0432', 'ELTMH0432', 'TXHOUSTD', 'TMH Physician Associates', 'Jennifer', '', 'Ogle', 'PAC', 'Physician Assistant Certified', '', '', NULL, 'O', '13802 Centerfield Dr Ste 300', 'Houston', 'Harris', 'TX', '77070', '2817370999', '2817370926', '13802 Centerfield Dr Ste 300', 'Houston', 'Harris', 'TX', '77070', '2817370999', '2817370926', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962467068', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.9694, -95.5506, NULL, NULL),
('300520570', 'ELTMH0320', 'ELTMH0320', 'TXHOUSTD', 'TMH Physician Associates', 'Rahul', '', 'Pandit', 'MD', 'Ophthalmology', '', '', NULL, 'O', '6560 Fannin St Ste 450', 'Houston', 'Harris', 'TX', '77030', '7134418843', '7137931636', '6560 Fannin Ste 450', 'Houston', 'Harris', 'TX', '77030', '7134418843', '7137931636', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1962467878', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.7109, -95.4002, NULL, NULL),
('300520570', 'ELTMH0021', 'ELTMH0021', 'TXHOUSTD', 'TMH Physician Associates', 'Paul', '', 'Jordan', 'ACNP', 'Acute Care Nurse Practitioner', '', '', NULL, 'O', '6565 Fannin St Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', '6565 Fannin Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962690263', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('300520570', 'ELTMH0023', 'ELTMH0023', 'TXHOUSTD', 'TMH Physician Associates', 'Amy', '', 'Martin', 'ACNP', 'Acute Care Nurse Practitioner', '', '', NULL, 'O', '6550 Fannin St Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415153', '7137906470', '6550 Fannin Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415153', '7137906470', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962709105', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0024', 'ELTMH0024', 'TXHOUSTD', 'TMH Physician Associates', 'Amy', '', 'Martin', 'ACNP', 'Acute Care Nurse Practitioner', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415125', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415125', '', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962709105', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0136', 'ELTMH0136', 'TXHOUSTD', 'TMH Physician Associates', 'Sima', '', 'Sapkota', 'FNP', 'Family Practice', '', '', NULL, 'O', '6550 Fannin St Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', '6550 Fannin Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', 'TMHPHOPCP', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1962770230', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0137', 'ELTMH0137', 'TXHOUSTD', 'TMH Physician Associates', 'Sima', '', 'Sapkota', 'FNP', 'Family Practice', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415129', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134415129', '', 'TMHPHOPCP', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1962770230', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0144', 'ELTMH0144', 'TXHOUSTD', 'TMH Physician Associates', 'Gregory', '', 'Terry', 'MD', 'Family Practice', '', '', NULL, 'O', '2610 N Alexander Dr Ste 201', 'Baytown', 'Harris', 'TX', '77520', '2814284411', '2814284384', '2610 North Alexander Dr Ste 201', 'Baytown', 'Harris', 'TX', '77520', '2814284411', '2814284384', 'TMHPHOPCP', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Willowbrook Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1972501773', 0, 'N', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0113', 'ELTMH0113', 'TXHOUSTD', 'TMH Physician Associates', 'David', '', 'Braunreiter', 'MD', 'Family Practice', '', '', NULL, 'O', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', 'TMHPHOPCP', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1972572055', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.6043, -95.634, NULL, NULL),
('571201170', 'ELTMH0477', 'ELTMH0477', 'TXHOUSTD', 'TMH Physician Organization', 'Clive', '', 'Shkedy', 'MD', 'Radiation Oncology', '', '', NULL, 'O', '16675 Southwest Fwy Ste 105', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2812747800', '2812747993', '16675 Southwest Fwy Ste 105', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2812747800', '2812747993', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1972595437', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.5897, -95.6331, NULL, NULL),
('571201170', 'ELTMH0478', 'ELTMH0478', 'TXHOUSTD', 'TMH Physician Organization', 'Clive', '', 'Shkedy', 'MD', 'Radiation Oncology', '', '', NULL, 'B', 'PO Box 4655', 'Houston', 'Harris', 'TX', '77210', '7137902637', NULL, 'PO Box 4655', 'Houston', 'Harris', 'TX', '77210', '7137902637', '', 'TMHPHOHSP', NULL, NULL, '0.00', '0.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1972595437', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0015', 'ELTMH0015', 'TXHOUSTD', 'TMH Physician Associates', 'James', '', 'Gundersen', 'ACNP', 'Acute Care Nurse Practitioner', '', '', NULL, 'O', '6565 Fannin St Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', '6565 Fannin Ste B452', 'Houston', 'Harris', 'TX', '77030', '7134413620', '7137902082', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972683274', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.7098, -95.3999, NULL, NULL),
('571201170', 'ELTMH0439', 'ELTMH0439', 'TXHOUSTD', 'TMH Physician Organization', 'Bothland', '', 'Ung', 'PAC', 'Physician Assistant Certified', '', '', NULL, 'O', '13802 Centerfield Dr Ste 185', 'Houston', 'Harris', 'TX', '77070', '2814774425', '2814774142', '13802 Centerfield Blvd Ste 185', 'Houston', 'Harris', 'TX', '77070', '2814774425', '2814774142', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972812493', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.967, -95.5471, NULL, NULL),
('571201170', 'ELTMH0440', 'ELTMH0440', 'TXHOUSTD', 'TMH Physician Organization', 'Bothland', '', 'Ung', 'PAC', 'Physician Assistant Certified', '', '', NULL, 'B', 'PO Box 4655', 'Houston', 'Harris', 'TX', '77210', '7134414347', NULL, 'PO Box 4655', 'Houston', 'Harris', 'TX', '77210', '7134414347', '', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972812493', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0429', 'ELTMH0429', 'TXHOUSTD', 'TMH Physician Associates', 'Laura', '', 'Murphy Fertak', 'PAC', 'Physician Assistant Certified', '', '', NULL, 'O', '6550 Fannin St Ste 2600', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137912058', '6550 Fannin Ste 2600', 'Houston', 'Harris', 'TX', '77030', '7134419000', '7137912058', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1982604658', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('371520288', 'ELTMH0392', 'ELTMH0392', 'TXHOUSTD', 'Methodist Pathology Associates', 'Jae Y', '', 'Ro', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', NULL, 'PO Box 4701', 'Houston', 'Harris', 'TX', '77210', '', '', '', NULL, 'TMHPHOPATH', '0.00', '0.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982652418', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0325', 'ELTMH0325', 'TXHOUSTD', 'TMH Physician Associates', 'Plinio', '', 'Caldera', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '13802 Centerfield Dr Ste 300', 'Houston', 'Harris', 'TX', '77070', '2817370999', '2817370926', '13802 Centerfield Dr Ste 300', 'Houston', 'Harris', 'TX', '77070', '2817370999', '2817370926', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1982668695', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.9694, -95.5506, NULL, NULL),
('300520570', 'ELTMH0107', 'ELTMH0107', 'TXHOUSTD', 'TMH Physician Associates', 'Dale', '', 'Hamilton', 'MD', 'Endocrinology', '', '', NULL, 'O', '6550 Fannin St Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', '6550 Fannin St Ste 1101', 'Houston', 'Harris', 'TX', '77030', '7134410006', '7137902727', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1982669875', 0, 'N', 0, '2013-03-22', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0019', 'ELTMH0019', 'TXHOUSTD', 'TMH Physician Associates', 'Janine', '', 'Hyden', 'ACNP', 'Acute Care Nurse Practitioner', '', '', NULL, 'O', '6550 Fannin St Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', '6550 Fannin Ste 1601', 'Houston', 'Harris', 'TX', '77030', '7134415141', '7137906470', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982700464', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('571201170', 'ELTMH0435', 'ELTMH0435', 'TXHOUSTD', 'TMH Physician Organization', 'Michelle', '', 'Scofield', 'PAC', 'Physician Assistant Certified', '', '', NULL, 'O', '16675 Southwest Fwy Ste 105', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2812747800', '2812747993', '16675 Southwest Fwy Ste 105', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2812747800', '2812747993', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1982793691', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.5897, -95.6331, NULL, NULL),
('571201170', 'ELTMH0436', 'ELTMH0436', 'TXHOUSTD', 'TMH Physician Organization', 'Michelle', '', 'Scofield', 'PAC', 'Physician Assistant Certified', '', '', NULL, 'B', 'PO Box 4655', 'Houston', 'Harris', 'TX', '77210', '7134411808', NULL, 'PO Box 4655', 'Houston', 'Harris', 'TX', '77210', '7134411808', '', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1982793691', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('300520570', 'ELTMH0044', 'ELTMH0044', 'TXHOUSTD', 'TMH Physician Associates', 'Margaret', '', 'Clark', 'ACNP', 'Adult Nurse Practitioner', '', '', NULL, 'O', '1429 Hwy 6 South Ste 303', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2813250005', '2813250039', '1429 Hwy 6 South Ste 303', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2813250005', '2813250039', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982950903', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.6021, -95.6325, NULL, NULL),
('571201170', 'ELTMH0172', 'ELTMH0172', 'TXHOUSTD', 'TMH Physician Organization', 'Aparna', '', 'Kamat', 'MD', 'Gynecologic Oncology', '', '', NULL, 'O', '6550 Fannin St Ste 901', 'Houston', 'Harris', 'TX', '77030', '7134411026', '7137902049', '6550 Fannin St Ste 901', 'Houston', 'Harris', 'TX', '77030', '7134411026', '7137902049', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1992732887', 0, 'N', 0, '2013-07-16', NULL, NULL, 29.7111, -95.3999, NULL, NULL),
('300520570', 'ELTMH0342', 'ELTMH0342', 'TXHOUSTD', 'TMH Physician Associates', 'Anthony', '', 'Muffoletto', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', '1201 Brooks St', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2816904678', '2815658808', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1992817993', 0, 'N', 0, '2012-12-27', NULL, NULL, 29.6043, -95.634, NULL, NULL),
('300520570', 'ELTMH0032', 'ELTMH0032', 'TXHOUSTD', 'TMH Physician Associates', 'Tiffany', '', 'Street', 'ACNP', 'Acute Care Nurse Practitioner', '', '', NULL, 'O', '6550 Fannin St Ste 1401', 'Houston', 'Harris', 'TX', '77030', '7134415200', '7134416298', '6550 Fannin Ste 1401', 'Houston', 'Harris', 'TX', '77030', '7134415200', '7134416298', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1992902738', 0, 'Y', 0, '2012-12-27', NULL, NULL, 29.712, -95.3995, NULL, NULL),
('300520570', 'ELTMH0033', 'ELTMH0033', 'TXHOUSTD', 'TMH Physician Associates', 'Tiffany', '', 'Street', 'ACNP', 'Acute Care Nurse Practitioner', '', '', NULL, 'B', 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', NULL, 'PO Box 4719', 'Houston', 'Harris', 'TX', '77210', '7134414347', '', 'TMHPHOSPC', 'TXHCPCTMH', NULL, '0.00', '50.00', '0.00', 6, '2013-01-01', '2013-09-30', 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1992902738', 0, 'Y', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('452715973', 'W12027707', 'W12027707', 'Sinclair', 'St Lukes Clinic Wood River', 'Rhonda', 'K', 'Robbins', 'MD', 'Gynecology', '', '', NULL, 'O', '100 Hospital Dr Ste 200', 'Ketchum', 'Blaine', 'ID', '83340', '2087278600', '2087278601', '100 Hospital Dr Ste 200', 'Ketchum', 'Blaine', 'ID', '83340', '2087278600', '2087278601', 'IDSINCLAIRD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-10-29', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962465997', 0, 'N', 0, '2014-02-19', NULL, NULL, 43.6485, -114.35, NULL, NULL),
('452715973', 'W12027704', 'W12027704', 'Sinclair', 'St Lukes Clinic Wood River', 'Jenny', 'A', 'Stireman', 'PA', 'Obstetrics and Gynecology', '', '', NULL, 'O', '100 Hospital Dr Ste 200', 'Ketchum', 'Blaine', 'ID', '83340', '2087278600', '2087278601', '100 Hospital Dr Ste 200', 'Ketchum', 'Blaine', 'ID', '83340', '2087278600', '2087278601', 'IDSINCLAIRD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-10-29', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1861689655', 0, 'N', 0, '2014-02-19', NULL, NULL, 43.6485, -114.35, NULL, NULL),
('271383837', 'ELGAS0087', 'ELGAS0087', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'John', 'C', 'Lee', 'MD', 'Pathology', '', '', NULL, 'O', '14052 W Petronella Dr Ste 201', 'Libertyville', 'Lake', 'IL', '60048', '8472446320', NULL, '14052 W Petronella Dr Ste 201', 'Libertyville', 'Lake', 'IL', '60048', '8472446320', '          ', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003063397', 0, 'Y', 0, '2013-04-09', NULL, NULL, 42.2721, -87.9069, NULL, NULL),
('271383837', 'ELGAS0034', 'ELGAS0034', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'John', 'C', 'Lee', 'MD', 'Pathology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003063397', 0, 'Y', 0, '2013-04-09', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0097', 'ELGAS0097', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Anna', 'M', 'Stegemann', 'DO', 'Anesthesiology', '', '', NULL, 'O', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003089707', 0, 'Y', 0, '2013-03-26', NULL, NULL, 42.2777, -87.877, NULL, NULL),
('271383837', 'ELGAS0044', 'ELGAS0044', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Anna', 'M', 'Stegemann', 'DO', 'Anesthesiology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003089707', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0068', 'ELGAS0068', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Fred', 'B', 'Rosenberg', 'MD', 'Gastroenterology', '', '', NULL, 'O', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1003817180', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.3588, -87.8995, NULL, NULL),
('271383837', 'ELGAS0139', 'ELGAS0139', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Fred', 'B', 'Rosenberg', 'MD', 'Gastroenterology', '', '', NULL, 'O', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1003817180', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0255, -87.6819, NULL, NULL),
('271383837', 'ELGAS0130', 'ELGAS0130', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Fred', 'B', 'Rosenberg', 'MD', 'Gastroenterology', '', '', NULL, 'O', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1003817180', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.1838, -87.8046, NULL, NULL),
('271383837', 'ELGAS0015', 'ELGAS0015', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Fred', 'B', 'Rosenberg', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1003817180', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0121', 'ELGAS0121', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Rajesh', 'S', 'Pillai', 'MD', 'Gastroenterology', '', '', NULL, 'O', '2000 McDonald Rd Ste 230', 'South Elgin', 'Kane', 'IL', '60177', '8478881300', '8478881341', '2000 McDonald Rd Ste 230', 'South Elgin', 'Kane', 'IL', '60177', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1083836027', 0, 'N', 0, '2013-03-26', NULL, NULL, 41.9851, -88.346, NULL, NULL),
('271383837', 'ELGAS0112', 'ELGAS0112', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Rajesh', 'S', 'Pillai', 'MD', 'Gastroenterology', '', '', NULL, 'O', '600 S Randall Rd', 'Algonquin', 'McHenry', 'IL', '60102', '8478881300', '8478881341', '600 S Randall Rd', 'Algonquin', 'McHenry', 'IL', '60102', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1083836027', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.1684, -88.3353, NULL, NULL),
('271383837', 'ELGAS0059', 'ELGAS0059', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Rajesh', 'S', 'Pillai', 'MD', 'Gastroenterology', '', '', NULL, 'O', '745 Fletcher Dr Ste 202', 'Elgin', 'Kane', 'IL', '60123', '8478881300', '8478881341', '745 Fletcher Dr Ste 202', 'Elgin', 'Kane', 'IL', '60123', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1083836027', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0545, -88.3352, NULL, NULL),
('271383837', 'ELGAS0006', 'ELGAS0006', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Rajesh', 'S', 'Pillai', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1083836027', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0118', 'ELGAS0118', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Lawrence', 'R', 'Kosinski', 'MD', 'Gastroenterology', '', '', NULL, 'O', '2000 McDonald Rd Ste 220', 'South Elgin', 'Kane', 'IL', '60177', '8478881300', '8478881341', '2000 McDonald Rd Ste 220', 'South Elgin', 'Kane', 'IL', '60177', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1093827107', 0, 'N', 0, '2013-04-05', NULL, NULL, 41.9851, -88.346, NULL, NULL),
('271383837', 'ELGAS0109', 'ELGAS0109', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Lawrence', 'R', 'Kosinski', 'MD', 'Gastroenterology', '', '', NULL, 'O', '600 S Randall Rd', 'Algonquin', 'McHenry', 'IL', '60102', '8478881300', '8478881341', '600 S Randall Rd', 'Algonquin', 'McHenry', 'IL', '60102', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1093827107', 0, 'N', 0, '2013-04-05', NULL, NULL, 42.1684, -88.3353, NULL, NULL),
('271383837', 'ELGAS0056', 'ELGAS0056', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Lawrence', 'R', 'Kosinski', 'MD', 'Gastroenterology', '', '', NULL, 'O', '745 Fletcher Dr Ste 202', 'Elgin', 'Kane', 'IL', '60123', '8478881300', '8478881341', '745 Fletcher Dr Ste 202', 'Elgin', 'Kane', 'IL', '60123', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1093827107', 0, 'N', 0, '2013-04-05', NULL, NULL, 42.0545, -88.3352, NULL, NULL),
('271383837', 'ELGAS0003', 'ELGAS0003', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Lawrence', 'R', 'Kosinski', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1093827107', 0, 'Y', 0, '2013-04-05', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0117', 'ELGAS0117', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Sonia', 'S', 'Godambe', 'MD', 'Gastroenterology', '', '', NULL, 'O', '2000 McDonald Rd Ste 230', 'South Elgin', 'Kane', 'IL', '60177', '8478881300', '8478881341', '2000 McDonald Rd Ste 230', 'South Elgin', 'Kane', 'IL', '60177', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1093964116', 0, 'N', 0, '2013-03-26', NULL, NULL, 41.9851, -88.346, NULL, NULL),
('271383837', 'ELGAS0108', 'ELGAS0108', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Sonia', 'S', 'Godambe', 'MD', 'Gastroenterology', '', '', NULL, 'O', '600 S Randall Rd', 'Algonquin', 'McHenry', 'IL', '60102', '8478881300', '8478881341', '600 S Randall Rd', 'Algonquin', 'McHenry', 'IL', '60102', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1093964116', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.1684, -88.3353, NULL, NULL),
('271383837', 'ELGAS0055', 'ELGAS0055', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Sonia', 'S', 'Godambe', 'MD', 'Gastroenterology', '', '', NULL, 'O', '745 Fletcher Dr Ste 202', 'Elgin', 'Kane', 'IL', '60123', '8478881300', '8478881341', '745 Fletcher Dr Ste 202', 'Elgin', 'Kane', 'IL', '60123', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1093964116', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0545, -88.3352, NULL, NULL),
('271383837', 'ELGAS0002', 'ELGAS0002', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Sonia', 'S', 'Godambe', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1093964116', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0073', 'ELGAS0073', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Bruce', 'D', 'Greenberg', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104817279', 0, 'N', 0, '2013-04-03', NULL, NULL, 42.0582, -87.9804, NULL, NULL),
('271383837', 'ELGAS0146', 'ELGAS0146', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Bruce', 'D', 'Greenberg', 'MD', 'Gastroenterology', '', '', NULL, 'O', '800 Biesterfield Rd  Wimmer Bldg Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', '800 Biesterfield Rd  Wimmer Bldg Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104817279', 0, 'N', 0, '2013-04-03', NULL, NULL, 42.0034, -88.0174, NULL, NULL),
('271383837', 'ELGAS0020', 'ELGAS0020', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Bruce', 'D', 'Greenberg', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104817279', 0, 'Y', 0, '2013-04-03', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0063', 'ELGAS0063', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Walter', 'R', 'Glaws', 'DO', 'Gastroenterology', '', '', NULL, 'O', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104828532', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.3588, -87.8995, NULL, NULL),
('271383837', 'ELGAS0134', 'ELGAS0134', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Walter', 'R', 'Glaws', 'DO', 'Gastroenterology', '', '', NULL, 'O', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104828532', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0255, -87.6819, NULL, NULL),
('271383837', 'ELGAS0125', 'ELGAS0125', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Walter', 'R', 'Glaws', 'DO', 'Gastroenterology', '', '', NULL, 'O', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104828532', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.1838, -87.8046, NULL, NULL),
('271383837', 'ELGAS0010', 'ELGAS0010', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Walter', 'R', 'Glaws', 'DO', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104828532', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0157', 'ELGAS0157', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Vincent', 'C', 'Muscarello', 'MD', 'Gastroenterology', '', '', NULL, 'O', '16525 S 106th Ct', 'Orland Park', 'Cook', 'IL', '60467', '7084259456', '7084259468', '16525 S 106th Ct', 'Orland Park', 'Cook', 'IL', '60467', '7084259456', '7084259468', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1134188675', 0, 'N', 0, '2013-04-03', NULL, NULL, 41.59, -87.8778, NULL, NULL),
('271383837', 'ELGAS0084', 'ELGAS0084', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Vincent', 'C', 'Muscarello', 'MD', 'Gastroenterology', '', '', NULL, 'O', '9921 Southwest Hwy', 'Oak Lawn', 'Cook', 'IL', '60453', '7084259456', '7084259468', '9921 Southwest Hwy', 'Oak Lawn', 'Cook', 'IL', '60453', '7084259456', '7084259468', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1134188675', 0, 'N', 0, '2013-04-03', NULL, NULL, 41.7121, -87.7768, NULL, NULL),
('271383837', 'ELGAS0031', 'ELGAS0031', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Vincent', 'C', 'Muscarello', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1134188675', 0, 'Y', 0, '2013-04-03', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0093', 'ELGAS0093', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Michael', 'R', 'Marinello', 'MD', 'Anesthesiology', '', '', NULL, 'O', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144249772', 0, 'Y', 0, '2013-03-26', NULL, NULL, 42.2777, -87.877, NULL, NULL),
('271383837', 'ELGAS0040', 'ELGAS0040', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Michael', 'R', 'Marinello', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144249772', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0077', 'ELGAS0077', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'David', 'J', 'Sales', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1164412508', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0582, -87.9804, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('271383837', 'ELGAS0150', 'ELGAS0150', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'David', 'J', 'Sales', 'MD', 'Gastroenterology', '', '', NULL, 'O', '800 Biesterfield Rd  Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', '800 Biesterfield Rd  Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1164412508', 0, 'N', 0, '2013-04-03', NULL, NULL, 42.0034, -88.0174, NULL, NULL),
('271383837', 'ELGAS0024', 'ELGAS0024', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'David', 'J', 'Sales', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1164412508', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0123', 'ELGAS0123', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Wei', 'M', 'Sun', 'MD', 'Gastroenterology', '', '', NULL, 'O', '2000 McDonald Rd Ste 230', 'South Elgin', 'Kane', 'IL', '60177', '8478881300', '8478881341', '2000 McDonald Rd Ste 230', 'South Elgin', 'Kane', 'IL', '60177', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1164487450', 0, 'N', 0, '2013-03-26', NULL, NULL, 41.9851, -88.346, NULL, NULL),
('271383837', 'ELGAS0114', 'ELGAS0114', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Wei', 'M', 'Sun', 'MD', 'Gastroenterology', '', '', NULL, 'O', '600 S Randall Rd', 'Algonquin', 'McHenry', 'IL', '60102', '8478881300', '8478881341', '600 S Randall Rd', 'Algonquin', 'McHenry', 'IL', '60102', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1164487450', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.1684, -88.3353, NULL, NULL),
('271383837', 'ELGAS0061', 'ELGAS0061', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Wei', 'M', 'Sun', 'MD', 'Gastroenterology', '', '', NULL, 'O', '745 Fletcher Dr Ste 202', 'Elgin', 'Kane', 'IL', '60123', '8478881300', '8478881341', '745 Fletcher Dr Ste 202', 'Elgin', 'Kane', 'IL', '60123', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1164487450', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0545, -88.3352, NULL, NULL),
('271383837', 'ELGAS0008', 'ELGAS0008', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Wei', 'M', 'Sun', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1164487450', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0155', 'ELGAS0155', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Brian', 'J', 'Blumenstein', 'MD', 'Gastroenterology', '', '', NULL, 'O', '16525 S 106th Ct', 'Orland Park', 'Cook', 'IL', '60467', '7084259456', '7084259468', '16525 S 106th Ct', 'Orland Park', 'Cook', 'IL', '60467', '7084259456', '7084259468', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194784645', 0, 'N', 0, '2013-03-26', NULL, NULL, 41.59, -87.8778, NULL, NULL),
('271383837', 'ELGAS0082', 'ELGAS0082', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Brian', 'J', 'Blumenstein', 'MD', 'Gastroenterology', '', '', NULL, 'O', '9921 Southwest Hwy', 'Oak Lawn', 'Cook', 'IL', '60453', '7084259456', '7084259468', '9921 Southwest Hwy', 'Oak Lawn', 'Cook', 'IL', '60453', '7084259456', '7084259468', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194784645', 0, 'N', 0, '2013-03-26', NULL, NULL, 41.7121, -87.7768, NULL, NULL),
('271383837', 'ELGAS0029', 'ELGAS0029', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Brian', 'J', 'Blumenstein', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194784645', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0065', 'ELGAS0065', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Everett', 'P', 'Kirch', 'MD', 'Gastroenterology', '', '', NULL, 'O', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1225030687', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.3588, -87.8995, NULL, NULL),
('271383837', 'ELGAS0136', 'ELGAS0136', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Everett', 'P', 'Kirch', 'MD', 'Gastroenterology', '', '', NULL, 'O', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1225030687', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0255, -87.6819, NULL, NULL),
('271383837', 'ELGAS0127', 'ELGAS0127', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Everett', 'P', 'Kirch', 'MD', 'Gastroenterology', '', '', NULL, 'O', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1225030687', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.1838, -87.8046, NULL, NULL),
('271383837', 'ELGAS0012', 'ELGAS0012', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Everett', 'P', 'Kirch', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1225030687', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0066', 'ELGAS0066', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Kevin', 'M', 'Liebovich', 'MD', 'Gastroenterology', '', '', NULL, 'O', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1235131673', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.3588, -87.8995, NULL, NULL),
('271383837', 'ELGAS0137', 'ELGAS0137', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Kevin', 'M', 'Liebovich', 'MD', 'Gastroenterology', '', '', NULL, 'O', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1235131673', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0255, -87.6819, NULL, NULL),
('271383837', 'ELGAS0128', 'ELGAS0128', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Kevin', 'M', 'Liebovich', 'MD', 'Gastroenterology', '', '', NULL, 'O', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1235131673', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.1838, -87.8046, NULL, NULL),
('271383837', 'ELGAS0013', 'ELGAS0013', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Kevin', 'M', 'Liebovich', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1235131673', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0119', 'ELGAS0119', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'William', 'A', 'Levis', 'MD', 'Gastroenterology', '', '', NULL, 'O', '2000 McDonald Rd Ste 230', 'South Elgin', 'Kane', 'IL', '60177', '8478881300', '8478881341', '2000 McDonald Rd Ste 230', 'South Elgin', 'Kane', 'IL', '60177', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1265512164', 0, 'N', 0, '2013-03-26', NULL, NULL, 41.9851, -88.346, NULL, NULL),
('271383837', 'ELGAS0110', 'ELGAS0110', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'William', 'A', 'Levis', 'MD', 'Gastroenterology', '', '', NULL, 'O', '600 S Randall Rd', 'Algonquin', 'McHenry', 'IL', '60102', '8478881300', '8478881341', '600 S Randall Rd', 'Algonquin', 'McHenry', 'IL', '60102', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1265512164', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.1684, -88.3353, NULL, NULL),
('271383837', 'ELGAS0057', 'ELGAS0057', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'William', 'A', 'Levis', 'MD', 'Gastroenterology', '', '', NULL, 'O', '745 Fletcher Dr Ste 202', 'Elgin', 'Kane', 'IL', '60123', '8478881300', '8478881341', '745 Fletcher Dr Ste 202', 'Elgin', 'Kane', 'IL', '60123', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1265512164', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0545, -88.3352, NULL, NULL),
('271383837', 'ELGAS0004', 'ELGAS0004', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'William', 'A', 'Levis', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1265512164', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0072', 'ELGAS0072', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Mitchell', 'B', 'Bernsen', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275523631', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0582, -87.9804, NULL, NULL),
('271383837', 'ELGAS0145', 'ELGAS0145', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Mitchell', 'B', 'Bernsen', 'MD', 'Gastroenterology', '', '', NULL, 'O', '800 Biesterfield Rd  Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', '800 Biesterfield Rd  Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275523631', 0, 'N', 0, '2013-04-03', NULL, NULL, 42.0034, -88.0174, NULL, NULL),
('271383837', 'ELGAS0019', 'ELGAS0019', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Mitchell', 'B', 'Bernsen', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275523631', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0091', 'ELGAS0091', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Rama', 'K', 'Kuchipudi', 'MD', 'Anesthesiology', '', '', NULL, 'O', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295700979', 0, 'Y', 0, '2014-02-14', NULL, NULL, 42.2777, -87.877, NULL, NULL),
('271383837', 'ELGAS0038', 'ELGAS0038', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Rama', 'K', 'Kuchipudi', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295700979', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0064', 'ELGAS0064', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Harsh', 'V', 'Gupta', 'MD', 'Gastroenterology', '', '', NULL, 'O', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1295727436', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.3588, -87.8995, NULL, NULL),
('271383837', 'ELGAS0135', 'ELGAS0135', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Harsh', 'V', 'Gupta', 'MD', 'Gastroenterology', '', '', NULL, 'O', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1295727436', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0255, -87.6819, NULL, NULL),
('271383837', 'ELGAS0126', 'ELGAS0126', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Harsh', 'V', 'Gupta', 'MD', 'Gastroenterology', '', '', NULL, 'O', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1295727436', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.1838, -87.8046, NULL, NULL),
('271383837', 'ELGAS0011', 'ELGAS0011', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Harsh', 'V', 'Gupta', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1295727436', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0086', 'ELGAS0086', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Richard', 'J', 'Clatch', 'MD', 'Pathology', '', '', NULL, 'O', '14052 W Petronella Dr Ste 201', 'Libertyville', 'Lake', 'IL', '60048', '8475491312', NULL, '14052 W Petronella Dr Ste 201', 'Libertyville', 'Lake', 'IL', '60048', '8475491312', '          ', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwestern Lake Forest Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1306815238', 0, 'Y', 0, '2013-07-02', NULL, NULL, 42.2721, -87.9069, NULL, NULL),
('271383837', 'ELGAS0033', 'ELGAS0033', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Richard', 'J', 'Clatch', 'MD', 'Pathology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8475491312', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8475491312', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwestern Lake Forest Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1306815238', 0, 'Y', 0, '2013-07-02', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0069', 'ELGAS0069', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Karen', 'S', 'Sable', 'MD', 'Gastroenterology', '', '', NULL, 'O', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1316949738', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.3588, -87.8995, NULL, NULL),
('271383837', 'ELGAS0140', 'ELGAS0140', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Karen', 'S', 'Sable', 'MD', 'Gastroenterology', '', '', NULL, 'O', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1316949738', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0255, -87.6819, NULL, NULL),
('271383837', 'ELGAS0131', 'ELGAS0131', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Karen', 'S', 'Sable', 'MD', 'Gastroenterology', '', '', NULL, 'O', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1316949738', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.1838, -87.8046, NULL, NULL),
('271383837', 'ELGAS0144', 'ELGAS0144', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Karen', 'S', 'Sable', 'MD', 'Gastroenterology', '', '', NULL, 'O', '9700 N Kenton Ste 103', 'Skokie', 'Cook', 'IL', '60076', '8474339840', '8474339842', '9700 N Kenton Ste 103', 'Skokie', 'Cook', 'IL', '60076', '8474339840', '8474339842', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1316949738', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0567, -87.7419, NULL, NULL),
('271383837', 'ELGAS0143', 'ELGAS0143', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Karen', 'S', 'Sable', 'MD', 'Gastroenterology', '', '', NULL, 'O', '9701 N Knox Ste 103', 'Skokie', 'Cook', 'IL', '60076', '8474339840', '8474339842', '9701 N Knox Ste 103', 'Skokie', 'Cook', 'IL', '60076', '8474339840', '8474339842', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1316949738', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0567, -87.7432, NULL, NULL),
('271383837', 'ELGAS0016', 'ELGAS0016', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Karen', 'S', 'Sable', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1316949738', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0078', 'ELGAS0078', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Jerrold', 'L', 'Schwartz', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336130491', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0582, -87.9804, NULL, NULL),
('271383837', 'ELGAS0151', 'ELGAS0151', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Jerrold', 'L', 'Schwartz', 'MD', 'Gastroenterology', '', '', NULL, 'O', '800 Biesterfield Rd  Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', '800 Biesterfield Rd  Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336130491', 0, 'N', 0, '2013-04-03', NULL, NULL, 42.0034, -88.0174, NULL, NULL),
('271383837', 'ELGAS0025', 'ELGAS0025', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Jerrold', 'L', 'Schwartz', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336130491', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0099', 'ELGAS0099', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Martin', 'J', 'Valente', 'MD', 'Anesthesiology', '', '', NULL, 'O', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356357651', 0, 'Y', 0, '2013-03-26', NULL, NULL, 42.2777, -87.877, NULL, NULL),
('271383837', 'ELGAS0046', 'ELGAS0046', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Martin', 'J', 'Valente', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356357651', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0106', 'ELGAS0106', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Darrel', 'A', 'Storbeck', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356360903', 0, 'Y', 0, '2013-03-26', NULL, NULL, 42.2777, -87.877, NULL, NULL),
('271383837', 'ELGAS0053', 'ELGAS0053', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Darrel', 'A', 'Storbeck', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356360903', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0104', 'ELGAS0104', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Mary', 'G', 'Kashmar', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356364293', 0, 'Y', 0, '2013-03-26', NULL, NULL, 42.2777, -87.877, NULL, NULL),
('271383837', 'ELGAS0051', 'ELGAS0051', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Mary', 'G', 'Kashmar', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356364293', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0095', 'ELGAS0095', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Julia', '', 'Milman', 'MD', 'Anesthesiology', '', '', NULL, 'O', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356507248', 0, 'Y', 0, '2013-03-26', NULL, NULL, 42.2777, -87.877, NULL, NULL),
('271383837', 'ELGAS0042', 'ELGAS0042', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Julia', '', 'Milman', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356507248', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0079', 'ELGAS0079', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Patricia', 'K', 'Sun', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1366626426', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0582, -87.9804, NULL, NULL),
('271383837', 'ELGAS0152', 'ELGAS0152', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Patricia', 'K', 'Sun', 'MD', 'Gastroenterology', '', '', NULL, 'O', '800 Biesterfield Rd  Wimmer Bldg Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', '800 Biesterfield Rd  Wimmer Bldg Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1366626426', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0034, -88.0174, NULL, NULL),
('271383837', 'ELGAS0026', 'ELGAS0026', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Patricia', 'K', 'Sun', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1366626426', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0122', 'ELGAS0122', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'James', 'G', 'Stinneford', 'MD', 'Gastroenterology', '', '', NULL, 'O', '2000 McDonald Rd Ste 230', 'South Elgin', 'Kane', 'IL', '60177', '8478881300', '8478881341', '2000 McDonald Rd Ste 230', 'South Elgin', 'Kane', 'IL', '60177', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1407968514', 0, 'N', 0, '2013-03-26', NULL, NULL, 41.9851, -88.346, NULL, NULL),
('271383837', 'ELGAS0113', 'ELGAS0113', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'James', 'G', 'Stinneford', 'MD', 'Gastroenterology', '', '', NULL, 'O', '600 S Randall Rd', 'Algonquin', 'McHenry', 'IL', '60102', '8478881300', '8478881341', '600 S Randall Rd', 'Algonquin', 'McHenry', 'IL', '60102', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1407968514', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.1684, -88.3353, NULL, NULL),
('271383837', 'ELGAS0060', 'ELGAS0060', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'James', 'G', 'Stinneford', 'MD', 'Gastroenterology', '', '', NULL, 'O', '745 Fletcher Dr Ste 202', 'Elgin', 'Kane', 'IL', '60123', '8478881300', '8478881341', '745 Fletcher Dr Ste 202', 'Elgin', 'Kane', 'IL', '60123', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1407968514', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0545, -88.3352, NULL, NULL),
('271383837', 'ELGAS0007', 'ELGAS0007', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'James', 'G', 'Stinneford', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1407968514', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0098', 'ELGAS0098', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Raghavender', '', 'Thunga', 'MD', 'Anesthesiology', '', '', NULL, 'O', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1437124054', 0, 'Y', 0, '2013-03-26', NULL, NULL, 42.2777, -87.877, NULL, NULL),
('271383837', 'ELGAS0045', 'ELGAS0045', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Raghavender', '', 'Thunga', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1437124054', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0076', 'ELGAS0076', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Joel', 'M', 'Lattin', 'DO', 'Gastroenterology', '', '', NULL, 'O', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437149895', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0582, -87.9804, NULL, NULL),
('271383837', 'ELGAS0149', 'ELGAS0149', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Joel', 'M', 'Lattin', 'DO', 'Gastroenterology', '', '', NULL, 'O', '800 Biesterfield Rd  Wimmer Bldg Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', '800 Biesterfield Rd  Wimmer Bldg Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437149895', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0034, -88.0174, NULL, NULL),
('271383837', 'ELGAS0023', 'ELGAS0023', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Joel', 'M', 'Lattin', 'DO', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437149895', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0120', 'ELGAS0120', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Joseph', '', 'Losurdi', 'MD', 'Gastroenterology', '', '', NULL, 'O', '2000 McDonald Rd Ste 230', 'South Elgin', 'Kane', 'IL', '60177', '8478881300', '8478881341', '2000 McDonald Rd Ste 230', 'South Elgin', 'Kane', 'IL', '60177', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1437261450', 0, 'N', 0, '2013-03-26', NULL, NULL, 41.9851, -88.346, NULL, NULL),
('271383837', 'ELGAS0111', 'ELGAS0111', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Joseph', '', 'Losurdi', 'MD', 'Gastroenterology', '', '', NULL, 'O', '600 S Randall Rd', 'Algonquin', 'McHenry', 'IL', '60102', '8478881300', '8478881341', '600 S Randall Rd', 'Algonquin', 'McHenry', 'IL', '60102', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1437261450', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.1684, -88.3353, NULL, NULL),
('271383837', 'ELGAS0058', 'ELGAS0058', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Joseph', '', 'Losurdi', 'MD', 'Gastroenterology', '', '', NULL, 'O', '745 Fletcher Dr Ste 202', 'Elgin', 'Kane', 'IL', '60123', '8478881300', '8478881341', '745 Fletcher Dr Ste 202', 'Elgin', 'Kane', 'IL', '60123', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1437261450', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0545, -88.3352, NULL, NULL),
('271383837', 'ELGAS0005', 'ELGAS0005', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Joseph', '', 'Losurdi', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1437261450', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0071', 'ELGAS0071', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Cynthia', 'A', 'Wait', 'MD', 'Gastroenterology', '', '', NULL, 'O', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1447252804', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.3588, -87.8995, NULL, NULL),
('271383837', 'ELGAS0142', 'ELGAS0142', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Cynthia', 'A', 'Wait', 'MD', 'Gastroenterology', '', '', NULL, 'O', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-04-03', 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1447252804', 0, 'N', 0, '2013-04-03', NULL, NULL, 42.0252, -87.6828, NULL, NULL),
('271383837', 'ELGAS0133', 'ELGAS0133', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Cynthia', 'A', 'Wait', 'MD', 'Gastroenterology', '', '', NULL, 'O', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1447252804', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.1838, -87.8046, NULL, NULL),
('271383837', 'ELGAS0018', 'ELGAS0018', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Cynthia', 'A', 'Wait', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1447252804', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0080', 'ELGAS0080', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Loren', 'B', 'White', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477543809', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0582, -87.9804, NULL, NULL),
('271383837', 'ELGAS0153', 'ELGAS0153', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Loren', 'B', 'White', 'MD', 'Gastroenterology', '', '', NULL, 'O', '800 Biesterfield Rd  Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', '800 Biesterfield Rd  Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477543809', 0, 'N', 0, '2013-04-03', NULL, NULL, 42.0034, -88.0174, NULL, NULL),
('271383837', 'ELGAS0027', 'ELGAS0027', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Loren', 'B', 'White', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477543809', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0090', 'ELGAS0090', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Divynag', 'R', 'Joshi', 'MD', 'Anesthesiology', '', '', NULL, 'O', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477587590', 0, 'Y', 0, '2013-03-26', NULL, NULL, 42.2777, -87.877, NULL, NULL),
('271383837', 'ELGAS0037', 'ELGAS0037', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Divynag', 'R', 'Joshi', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477587590', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0154', 'ELGAS0154', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Thomas', 'R', 'Arndt', 'MD', 'Gastroenterology', '', '', NULL, 'O', '16525 S 106th Ct', 'Orland Park', 'Cook', 'IL', '60467', '7084259456', '7084259468', '16525 S 106th Ct', 'Orland Park', 'Cook', 'IL', '60467', '7084259456', '7084259468', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1487614210', 0, 'N', 0, '2013-03-26', NULL, NULL, 41.59, -87.8778, NULL, NULL),
('271383837', 'ELGAS0081', 'ELGAS0081', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Thomas', 'R', 'Arndt', 'MD', 'Gastroenterology', '', '', NULL, 'O', '9921 Southwest Hwy', 'Oak Lawn', 'Cook', 'IL', '60453', '7084259456', '7084259468', '9921 Southwest Hwy', 'Oak Lawn', 'Cook', 'IL', '60453', '7084259456', '7084259468', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1487614210', 0, 'N', 0, '2013-03-26', NULL, NULL, 41.7121, -87.7768, NULL, NULL),
('271383837', 'ELGAS0028', 'ELGAS0028', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Thomas', 'R', 'Arndt', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1487614210', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0092', 'ELGAS0092', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Latarzyna', '', 'Klimas Osolkowski', 'MD', 'Anesthesiology', '', '', NULL, 'O', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497780597', 0, 'Y', 0, '2013-03-26', NULL, NULL, 42.2777, -87.877, NULL, NULL),
('271383837', 'ELGAS0039', 'ELGAS0039', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Latarzyna', '', 'Klimas Osolkowski', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497780597', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0096', 'ELGAS0096', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Olga', '', 'Gorenyuk', 'MD', 'Anesthesiology', '', '', NULL, 'O', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508057373', 0, 'Y', 0, '2013-03-26', NULL, NULL, 42.2777, -87.877, NULL, NULL),
('271383837', 'ELGAS0043', 'ELGAS0043', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Olga', '', 'Gorenyuk', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508057373', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0070', 'ELGAS0070', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'John', 'M', 'Vainder', 'MD', 'Gastroenterology', '', '', NULL, 'O', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1508858226', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.3588, -87.8995, NULL, NULL),
('271383837', 'ELGAS0141', 'ELGAS0141', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'John', 'M', 'Vainder', 'MD', 'Gastroenterology', '', '', NULL, 'O', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1508858226', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0255, -87.6819, NULL, NULL),
('271383837', 'ELGAS0132', 'ELGAS0132', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'John', 'M', 'Vainder', 'MD', 'Gastroenterology', '', '', NULL, 'O', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1508858226', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.1838, -87.8046, NULL, NULL),
('271383837', 'ELGAS0017', 'ELGAS0017', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'John', 'M', 'Vainder', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1508858226', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0089', 'ELGAS0089', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'David', 'D', 'Wang', 'MD', 'Pathology', '', '', NULL, 'O', '14052 W Petronella Dr Ste 201', 'Libertyville', 'Lake', 'IL', '60048', '8475491312', NULL, '14052 W Petronella Dr Ste 201', 'Libertyville', 'Lake', 'IL', '60048', '8475491312', '          ', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1548238611', 0, 'Y', 0, '2013-07-02', NULL, NULL, 42.2721, -87.9069, NULL, NULL),
('271383837', 'ELGAS0036', 'ELGAS0036', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'David', 'D', 'Wang', 'MD', 'Pathology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8475491312', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8475491312', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1548238611', 0, 'Y', 0, '2013-07-02', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0105', 'ELGAS0105', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Ilia', 'S', 'Panov', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588800296', 0, 'Y', 0, '2014-02-11', NULL, NULL, 42.2777, -87.877, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('271383837', 'ELGAS0052', 'ELGAS0052', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Ilia', 'S', 'Panov', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588800296', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0088', 'ELGAS0088', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Thomas', 'F', 'Mientus', 'MD', 'Pathology', '', '', NULL, 'O', '14052 W Petronella Dr Ste 201', 'Libertyville', 'Lake', 'IL', '60048', '8475491312', NULL, '14052 W Petronella Dr Ste 201', 'Libertyville', 'Lake', 'IL', '60048', '8475491312', '          ', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwestern Lake Forest Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1649248824', 0, 'Y', 0, '2013-07-02', NULL, NULL, 42.2721, -87.9069, NULL, NULL),
('271383837', 'ELGAS0035', 'ELGAS0035', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Thomas', 'F', 'Mientus', 'MD', 'Pathology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8475491312', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8475491312', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwestern Lake Forest Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1649248824', 0, 'Y', 0, '2013-07-02', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0101', 'ELGAS0101', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Laura', 'E', 'Berman', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1689810392', 0, 'Y', 0, '2013-03-26', NULL, NULL, 42.2777, -87.877, NULL, NULL),
('271383837', 'ELGAS0048', 'ELGAS0048', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Laura', 'E', 'Berman', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1689810392', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0102', 'ELGAS0102', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Jeffrey', 'S', 'Dirst', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1700804598', 0, 'Y', 0, '2013-03-26', NULL, NULL, 42.2777, -87.877, NULL, NULL),
('271383837', 'ELGAS0049', 'ELGAS0049', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Jeffrey', 'S', 'Dirst', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1700804598', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0075', 'ELGAS0075', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'David', 'J', 'Kim', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1730170804', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0582, -87.9804, NULL, NULL),
('271383837', 'ELGAS0148', 'ELGAS0148', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'David', 'J', 'Kim', 'MD', 'Gastroenterology', '', '', NULL, 'O', '800 Biesterfield Rd  Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', '800 Biesterfield Rd  Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1730170804', 0, 'N', 0, '2013-04-03', NULL, NULL, 42.0034, -88.0174, NULL, NULL),
('271383837', 'ELGAS0022', 'ELGAS0022', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'David', 'J', 'Kim', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1730170804', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0074', 'ELGAS0074', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Mitchell', 'S', 'Kaplan', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', '1415 S Arlington Heights Rd', 'Arlington Heights', 'Cook', 'IL', '60005', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1760536130', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0582, -87.9804, NULL, NULL),
('271383837', 'ELGAS0147', 'ELGAS0147', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Mitchell', 'S', 'Kaplan', 'MD', 'Gastroenterology', '', '', NULL, 'O', '800 Biesterfield Rd  Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', '800 Biesterfield Rd  Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1760536130', 0, 'N', 0, '2013-04-03', NULL, NULL, 42.0034, -88.0174, NULL, NULL),
('271383837', 'ELGAS0021', 'ELGAS0021', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Mitchell', 'S', 'Kaplan', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1760536130', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0103', 'ELGAS0103', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Maria', '', 'Hobbs', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1770523243', 0, 'Y', 0, '2013-03-26', NULL, NULL, 42.2777, -87.877, NULL, NULL),
('271383837', 'ELGAS0050', 'ELGAS0050', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Maria', '', 'Hobbs', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1770523243', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0116', 'ELGAS0116', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Gregory', 'R', 'Gambla', 'DO', 'Gastroenterology', '', '', NULL, 'O', '2000 McDonald Rd Ste 230', 'South Elgin', 'Kane', 'IL', '60177', '8478881300', '8478881341', '2000 McDonald Rd Ste 230', 'South Elgin', 'Kane', 'IL', '60177', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1801832167', 0, 'N', 0, '2013-03-26', NULL, NULL, 41.9851, -88.346, NULL, NULL),
('271383837', 'ELGAS0107', 'ELGAS0107', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Gregory', 'R', 'Gambla', 'DO', 'Gastroenterology', '', '', NULL, 'O', '600 S Randall Rd', 'Algonquin', 'McHenry', 'IL', '60102', '8478881300', '8478881341', '600 S Randall Rd', 'Algonquin', 'McHenry', 'IL', '60102', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1801832167', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.1684, -88.3353, NULL, NULL),
('271383837', 'ELGAS0054', 'ELGAS0054', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Gregory', 'R', 'Gambla', 'DO', 'Gastroenterology', '', '', NULL, 'O', '745 Fletcher Dr Ste 202', 'Elgin', 'Kane', 'IL', '60123', '8478881300', '8478881341', '745 Fletcher Dr Ste 202', 'Elgin', 'Kane', 'IL', '60123', '8478881300', '8478881341', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1801832167', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0545, -88.3352, NULL, NULL),
('271383837', 'ELGAS0001', 'ELGAS0001', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Gregory', 'R', 'Gambla', 'DO', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1801832167', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0067', 'ELGAS0067', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Jonathan', 'A', 'Rosenberg', 'MD', 'Gastroenterology', '', '', NULL, 'O', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', '20 Tower Ct Ste C', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1811150725', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.3588, -87.8995, NULL, NULL),
('271383837', 'ELGAS0138', 'ELGAS0138', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Jonathan', 'A', 'Rosenberg', 'MD', 'Gastroenterology', '', '', NULL, 'O', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', '800 Austin St  West Tower Ste 403', 'Evanston', 'Cook', 'IL', '60202', '8474919020', '8474910182', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1811150725', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.0255, -87.6819, NULL, NULL),
('271383837', 'ELGAS0129', 'ELGAS0129', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Jonathan', 'A', 'Rosenberg', 'MD', 'Gastroenterology', '', '', NULL, 'O', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1811150725', 0, 'N', 0, '2013-03-26', NULL, NULL, 42.1838, -87.8046, NULL, NULL),
('271383837', 'ELGAS0014', 'ELGAS0014', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Jonathan', 'A', 'Rosenberg', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1811150725', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0156', 'ELGAS0156', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Wayne', 'C', 'Lue', 'MD', 'Gastroenterology', '', '', NULL, 'O', '16525 S 106th Ct', 'Orland Park', 'Cook', 'IL', '60467', '7084259456', '7084259468', '16525 S 106th Ct', 'Orland Park', 'Cook', 'IL', '60467', '7084259456', '7084259468', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1922068428', 0, 'N', 0, '2013-03-26', NULL, NULL, 41.59, -87.8778, NULL, NULL),
('271383837', 'ELGAS0083', 'ELGAS0083', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Wayne', 'C', 'Lue', 'MD', 'Gastroenterology', '', '', NULL, 'O', '9921 Southwest Hwy', 'Oak Lawn', 'Cook', 'IL', '60453', '7084259456', '7084259468', '9921 Southwest Hwy', 'Oak Lawn', 'Cook', 'IL', '60453', '7084259456', '7084259468', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1922068428', 0, 'N', 0, '2013-03-26', NULL, NULL, 41.7121, -87.7768, NULL, NULL),
('271383837', 'ELGAS0030', 'ELGAS0030', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Wayne', 'C', 'Lue', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1922068428', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0100', 'ELGAS0100', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Yaser', '', 'Wafai', 'MD', 'Anesthesiology', '', '', NULL, 'O', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1952315392', 0, 'Y', 0, '2014-02-11', NULL, NULL, 42.2777, -87.877, NULL, NULL),
('271383837', 'ELGAS0047', 'ELGAS0047', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Yaser', '', 'Wafai', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1952315392', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0094', 'ELGAS0094', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Steven', 'C', 'Marquardt', 'MD', 'Anesthesiology', '', '', NULL, 'O', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', '101 S Waukegan Rd Ste 980', 'Lake Bluff', 'Lake', 'IL', '60044', '8474571060', '8476048711', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972578227', 0, 'Y', 0, '2013-03-26', NULL, NULL, 42.2777, -87.877, NULL, NULL),
('271383837', 'ELGAS0041', 'ELGAS0041', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Steven', 'C', 'Marquardt', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972578227', 0, 'Y', 0, '2013-03-26', NULL, NULL, 0, 0, NULL, NULL),
('271383837', 'ELGAS0158', 'ELGAS0158', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Samir', 'A', 'Patel', 'MD', 'Gastroenterology', '', '', NULL, 'O', '16525 S 106th Ct', 'Orland Park', 'Cook', 'IL', '60467', '7084259456', '7084259468', '16525 S 106th Ct', 'Orland Park', 'Cook', 'IL', '60467', '7084259456', '7084259468', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1982664736', 0, 'N', 0, '2013-04-03', NULL, NULL, 41.59, -87.8778, NULL, NULL),
('271383837', 'ELGAS0085', 'ELGAS0085', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Samir', 'A', 'Patel', 'MD', 'Gastroenterology', '', '', NULL, 'O', '9921 Southwest Hwy', 'Oak Lawn', 'Cook', 'IL', '60453', '7084259456', '7084259468', '9921 Southwest Hwy', 'Oak Lawn', 'Cook', 'IL', '60453', '7084259456', '7084259468', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1982664736', 0, 'N', 0, '2013-04-03', NULL, NULL, 41.7121, -87.7768, NULL, NULL),
('271383837', 'ELGAS0032', 'ELGAS0032', 'ILCHIGSTD', 'Illinois Gastroenterology Group', 'Samir', 'A', 'Patel', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'PO BOX 7630', 'Gurnee', 'Lake', 'IL', '60031', '8472442960', '8472442986', 'CHIG16', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1982664736', 0, 'Y', 0, '2013-04-03', NULL, NULL, 0, 0, NULL, NULL),
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('752488356', 'W12027845', 'W12027845', 'TXDALSTD', 'Center for Family Medicine', '', '', 'Center for Family Medicine PA', '', 'Family Practice', '', '', NULL, 'O', '1906 US Hwy 82 W Ste 200', 'Sherman', 'Grayson', 'TX', '75092', '9038928398', '9038927903', '1906 US Hwy 82 W Ste 200', 'Sherman', 'Grayson', 'TX', '75092', '9038928398', '9038927903', 'DALLAS1', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB', '1780808832', 0, 'Y', 0, '2013-12-19', NULL, NULL, 33.6675, -96.5984, NULL, NULL),
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('752488356', 'W12027853', 'W12027853', 'TXDALSTD', 'Center for Family Medicine', 'Bradley', 'G', 'Hodge', 'MD', 'Family Practice', '', '', NULL, 'O', '1906 US Hwy 82 W Ste 200', 'Sherman', 'Grayson', 'TX', '75092', '9038928398', '9038927903', '1906 US Hwy 82 W Ste 200', 'Sherman', 'Grayson', 'TX', '75092', '9038928398', '9038927903', 'DALLAS1', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB', '1750470704', 0, 'N', 0, '2013-12-19', NULL, NULL, 33.6675, -96.5984, NULL, NULL),
('752488356', 'W12027855', 'W12027855', 'TXDALSTD', 'Center for Family Medicine', 'Ronald', 'A', 'Woods', 'MD', 'Family Practice', '', '', NULL, 'O', '1906 US Hwy 82 W Ste 200', 'Sherman', 'Grayson', 'TX', '75092', '9038928398', '9038927903', '1906 US Hwy 82 W Ste 200', 'Sherman', 'Grayson', 'TX', '75092', '9038928398', '9038927903', 'DALLAS1', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB', '1659460608', 0, 'Y', 0, '2013-12-19', NULL, NULL, 33.6675, -96.5984, NULL, NULL),
('752488356', 'W12027857', 'W12027857', 'TXDALSTD', 'Center for Family Medicine', 'Jasyn', '', 'Haney', 'MD', 'Family Practice', '', '', NULL, 'O', '1906 US Hwy 82 W Ste 200', 'Sherman', 'Grayson', 'TX', '75092', '9038928398', '9038927903', '1906 US Hwy 82 W Ste 200', 'Sherman', 'Grayson', 'TX', '75092', '9038928398', '9038927903', 'DALLAS1', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB', '1780773739', 0, 'N', 0, '2013-12-19', NULL, NULL, 33.6675, -96.5984, NULL, NULL),
('200187041', 'W12027858', 'W12027858', 'TXHOUSTD', 'HC MEDICAL DOCTORS', 'Hung', 'T', 'Nguyen', 'MD', 'Internal Medicine', '', '', NULL, 'O', '11810 FM 1960 W', 'Houston', 'Harris', 'TX', '77065', '8329127111', '8329127117', '11810 FM 1960 W', 'Houston', 'Harris', 'TX', '77065', '8329127111', '8329127117', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790784288', 0, 'N', 0, '2013-05-24', NULL, NULL, 29.9255, -95.5973, NULL, NULL),
('460711941', 'W12026112', 'W12026112', 'UT01', 'University of Utah Nero Critical Care', '', '', 'University of Utah Nero Critical Care', '', 'Neurology', '', '', NULL, 'O', '175 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015857575', NULL, '175 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015857575', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2012-11-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659628394', 0, 'N', 0, '2012-12-28', NULL, NULL, 40.7685, -111.837, NULL, NULL),
('460711441', 'W12026108', 'W12026108', 'UT01', 'University of Utah Neuromuscular', '', '', 'University of Utah Neuromuscular', '', 'Neurology', '', '', NULL, 'O', '175 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015857575', NULL, '175 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015857575', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2012-11-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336496074', 0, 'N', 0, '2012-12-28', NULL, NULL, 40.7685, -111.837, NULL, NULL),
('460711441', 'W12026110', 'W12026110', 'UT01', 'University of Utah Neuromuscular', '', '', 'University of Utah Neuromuscular', '', 'Neurology', '', '', NULL, 'B', 'PO Box 413027', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133900', NULL, 'PO Box 413027', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133900', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2012-11-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336496074', 0, 'N', 0, '2012-12-28', NULL, NULL, 0, 0, NULL, NULL),
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('010562155', 'W12027837', 'W12027837', 'TXDALSTD', 'Kids Wellness Center', 'Veronica', '', 'Forsythe', 'MD', 'Pediatrics', '', '', NULL, 'O', '3228 I-30 Ste 300', 'Mesquite', 'Dallas', 'TX', '75150', '9724806972', '9726987641', '3228 I-30 Ste 300', 'Mesquite', 'Dallas', 'TX', '75150', '9724806972', '9726987641', 'DALLAS1', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1457492381', 0, 'N', 0, '2012-12-28', NULL, NULL, 32.813, -96.6478, NULL, NULL),
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('010562155', 'W12027834', 'W12027834', 'TXDALSTD', 'Pediatric Clinic of Mesquite', 'Martin', '', 'Gomez', 'MD', 'Pediatrics', '', '', NULL, 'O', '3230 I-30 Ste 100', 'Mesquite', 'Dallas', 'TX', '75150', '9726821791', '9726987641', '3230 I-30 Ste 100', 'Mesquite', 'Dallas', 'TX', '75150', '9726821791', '9726987641', 'DALLAS1', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932299831', 0, 'N', 0, '2012-12-28', NULL, NULL, 32.8129, -96.6479, NULL, NULL),
('830199236', 'W12027860', 'W12027860', 'WYT2', 'Yellowstone Behavioral Health Center', 'Kristi', '', 'Zola', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'O', '2538 Big Horn Ave', 'Cody', 'Park', 'WY', '82414', '3075872197', NULL, '2538 Big Horn Ave', 'Cody', 'Park', 'WY', '82414', '3075872197', '          ', 'MA', '', '', '0.00', '40.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1437442639', 0, 'N', 0, '2013-07-24', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W12027861', 'W12027861', 'UT01', 'Associates in Orthopaedic Surgery', 'Kavon', 'S', 'Rahimzadegan', 'PA-C', 'Orthopedic Surgery', '', '', NULL, 'O', '3336 S Pioneer Pkwy Ste 102', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643925', '8019643928', '3336 S Pioneer Pkwy Ste 102', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643925', '8019643928', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2012-10-01', NULL, 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB', '1366793622', 0, 'N', 0, '2013-11-14', NULL, NULL, 40.6991, -111.99, NULL, NULL),
('621801973', 'W12027862', 'W12027862', 'UT01', 'Physician Group of Utah, Inc', 'Kavon', 'S', 'Rahimzadegan', 'PA-C', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 281415', 'Atlanta', 'Fulton', 'GA', '30384', '8019843418', '8019843479', 'PO Box 281415', 'Atlanta', 'Fulton', 'GA', '30384', '8019843418', '8019843479', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2012-10-01', NULL, 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB', '1366793622', 0, 'N', 0, '2013-11-14', NULL, NULL, 0, 0, NULL, NULL),
('742979042', 'W12027864', 'W12027864', 'TXSATSTD', 'Remington Oaks Family Practice', 'Neal', 'S', 'Meritz', 'MD', 'Family Practice', '', '', NULL, 'O', '525 Oak Ctr Dr Ste 150', 'San Antonio', 'Bexar', 'TX', '78258', '2102974550', '2102970450', '525 Oak Ctr Dr Ste 150', 'San Antonio', 'Bexar', 'TX', '78258', '2102974550', '2102970450', 'SANANTONIO1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, '', '', 'HCFA|UB', '1306861299', 0, 'N', 0, '2013-06-03', NULL, NULL, 29.6189, -98.4917, NULL, NULL),
('742979042', 'W12027865', 'W12027865', 'TXSATSTD', 'Remington Oaks Family Practice', 'Cynthia', 'S', 'Saucedo', 'MD', 'Family Practice', '', '', NULL, 'O', '525 Oak Ctr Dr Ste 150', 'San Antonio', 'Bexar', 'TX', '78258', '2102974550', '2102970450', '525 Oak Ctr Dr Ste 150', 'San Antonio', 'Bexar', 'TX', '78258', '2102974550', '2102970450', 'SANANTONIO1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, '', '', 'HCFA|UB', '1114943271', 0, 'N', 0, '2013-06-03', NULL, NULL, 29.6189, -98.4917, NULL, NULL),
('742979042', 'W12027866', 'W12027866', 'TXSATSTD', 'Remington Oaks Family Practice', 'Laura', 'A', 'Villarreal', 'MD', 'Family Practice', '', '', NULL, 'O', '525 Oak Ctr Dr Ste 150', 'San Antonio', 'Bexar', 'TX', '78258', '2102974550', '2102970450', '525 Oak Ctr Dr Ste 150', 'San Antonio', 'Bexar', 'TX', '78258', '2102974550', '2102970450', 'SANANTONIO1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, '', '', 'HCFA|UB', '1023033826', 0, 'N', 0, '2013-06-03', NULL, NULL, 29.6189, -98.4917, NULL, NULL),
('760512625', 'W12027795', 'W12027795', 'TXHOUSTD', 'Houston Eye Associates', '', '', 'Houston Eye Associates', '', 'Ophthalmology', '', '', NULL, 'M', '7155 Old Katy Rd Ste N100', 'Houston', 'Harris', 'TX', '77024', '          ', NULL, '7155 Old Katy Rd Ste N100', 'Houston', 'Harris', 'TX', '77024', '          ', '          ', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000010029', 0, 'N', 0, '2013-03-20', NULL, NULL, 0, 0, NULL, NULL),
('760512625', 'W12027796', 'W12027796', 'TXHOUSTD', 'Houston Eye Associates', '', '', 'Houston Eye Associates', '', 'Ophthalmology', '', '', NULL, 'B', 'PO Box 4958', 'Houston', 'Harris', 'TX', '77210', '          ', NULL, 'PO Box 4958', 'Houston', 'Harris', 'TX', '77210', '          ', '          ', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000010029', 0, 'N', 0, '2013-03-20', NULL, NULL, 0, 0, NULL, NULL),
('452715973', 'W12027747', 'W12027747', 'Sinclair', 'St Lukes Clinic Wood River', 'Dan', 'S', 'Fairman', 'MD', 'Internal Medicine', '', '', NULL, 'O', '100 Hospital Dr Ste 201', 'Ketchum', 'Blaine', 'ID', '83340', '2087278600', '2087278601', '100 Hospital Dr Ste 201', 'Ketchum', 'Blaine', 'ID', '83340', '2087278600', '2087278601', 'IDSINCLAIRD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-10-29', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1023059250', 0, 'N', 0, '2014-02-19', NULL, NULL, 43.6485, -114.35, NULL, NULL),
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('942854057', 'W12027881', 'W12027881', 'UTIHCPHY', 'Dixie Inpatient Psychiatry', 'Matt', 'T', 'Webb', 'APRN', 'Mental Health', '', '', NULL, 'O', '544 S 400 E', 'St George', 'Washington', 'UT', '84770', '4356884343', '4356885331', '544 S 400 E', 'St George', 'Washington', 'UT', '84770', '4356884343', '4356885331', 'IHCAPRN', '', '', '0.00', '100.00', '0.00', 8, '2012-09-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1215291992', 0, 'Y', 0, '2012-12-31', NULL, NULL, 37.0989, -113.575, NULL, NULL),
('942854057', 'W12027883', 'W12027883', 'UTIHCPHY', 'Southwest Regional Cancer-Cedar City', 'Bakhti', 'J', 'Sinor', 'MD', 'Hematology and Oncology', '', '', NULL, 'O', '1303 N Main St', 'Cedar City', 'Iron', 'UT', '84720', '4358685690', '4356349852', '1303 N Main St', 'Cedar City', 'Iron', 'UT', '84720', '4358685690', '4356349852', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2012-09-04', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477540177', 0, 'Y', 0, '2012-12-31', NULL, NULL, 37.7003, -113.064, NULL, NULL),
('942854057', 'W12027885', 'W12027885', 'UTIHCPHY', 'Southwest Regional Cancer Clinic', 'Bakhti', 'J', 'Sinor', 'MD', 'Hematology and Oncology', '', '', NULL, 'O', '544 S 400 E', 'St George', 'Washington', 'UT', '84770', '4356884900', '4356884901', '544 S 400 E', 'St George', 'Washington', 'UT', '84770', '4356884900', '4356884901', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2012-09-04', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477540177', 0, 'Y', 0, '2012-12-31', NULL, NULL, 37.0989, -113.575, NULL, NULL),
('942854057', 'W12027887', 'W12027887', 'UTIHCPHY', 'Heber Valley Clinic', 'Lance', 'D', 'Robert', 'DO', 'Urgent Care', '', '', NULL, 'O', '1473 S Hwy 40 Ste E ', 'Heber City', 'Wasatch', 'UT', '84032', '4356574400', '4356574460', '1473 S Hwy 40 Ste E ', 'Heber City', 'Wasatch', 'UT', '84032', '4356574400', '4356574460', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2012-09-06', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578852174', 0, 'Y', 0, '2012-12-31', NULL, NULL, 40.4893, -111.409, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('942854057', 'W12027888', 'W12027888', 'UTIHCPHY', 'Mt Pleasant Clinic', 'J', 'Kent', 'McGregor', 'DO', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1100 S Medical Dr', 'Mount Pleasant', 'Sanpete', 'UT', '84647', '4354623471', '4354623354', '1100 S Medical Dr', 'Mount Pleasant', 'Sanpete', 'UT', '84647', '4354623471', '4354623354', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2012-10-01', '2014-03-30', 0, 0, 0, 'Sanpete Valley Hospital', '', '', '', 'HCFA|UB|', '1407053010', 0, 'Y', 0, '2014-05-12', NULL, NULL, 39.5318, -111.461, NULL, NULL),
('942854057', 'W12027890', 'W12027890', 'UTIHCPHY', 'Heber Valley Clinic', 'Jewel', 'E', 'Maeda', 'CNM', 'Certified Nurse Midwife', '', '', NULL, 'O', '1473 S Hwy 40 Ste E', 'Heber City', 'Wasatch', 'UT', '84032', '4356574400', '4356574460', '1473 S Hwy 40 Ste E', 'Heber City', 'Wasatch', 'UT', '84032', '4356574400', '4356574460', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2012-10-16', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1679669022', 0, 'Y', 0, '2014-04-08', NULL, NULL, 40.4893, -111.409, NULL, NULL),
('942854057', 'W12027891', 'W12027891', 'UTIHCPHY', 'Holladay Pediatrics North', 'Janice', 'B', 'Lamborn', 'APRN', 'Pediatrics', '', '', NULL, 'O', '2160 E 4500 S', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8012784693', '8012784850', '2160 E 4500 S', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8012784693', '8012784850', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2012-11-01', NULL, 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1033121918', 0, 'Y', 0, '2013-06-03', NULL, NULL, 40.6742, -111.829, NULL, NULL),
('942854057', 'W12027892', 'W12027892', 'UTIHCPHY', 'Cache Valley Heart Clinic', 'Michael', 'G', 'Henderson', 'PA-C', 'Emergency Medicine', 'Physician Assistant', 'Neurosurgery', NULL, 'O', '1300 N 500 E Ste 320', 'Logan', 'Cache', 'UT', '84341', '4357162200', '4357162220', '1300 N 500 E Ste 320', 'Logan', 'Cache', 'UT', '84341', '4357162200', '4357162220', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2012-10-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1265423594', 0, 'Y', 0, '2014-05-27', NULL, NULL, 41.7563, -111.821, NULL, NULL),
('942854057', 'W12027894', 'W12027894', 'UTIHCPHY', 'Sunset InstaCare', 'Clifford', 'Vernor', 'Dunn', 'MD', 'Urgent Care', '', '', NULL, 'O', '1739 W Sunset Blvd', 'St George', 'Washington', 'UT', '84770', '4356346050', '4356346033', '1739 W Sunset Blvd', 'St George', 'Washington', 'UT', '84770', '4356346050', '4356346033', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2012-09-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548468036', 0, 'Y', 0, '2012-12-31', NULL, NULL, 37.1227, -113.62, NULL, NULL),
('760508619', 'W12027897', 'W12027897', 'TXHOUSTD', 'Texas Gulf Coast Medical Group', '', '', 'Texas Gulf Coast Medical Group', '', 'Clinics', '', '', NULL, 'O', '250 Blossom Ste 300 & 400', 'Webster', 'Harris', 'TX', '77598', '2816041300', '2817240385', '250 Blossom Ste 300 & 400', 'Webster', 'Harris', 'TX', '77598', '2816041300', '2817240385', 'GULFCSTMED', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB', '1962512160', 0, 'Y', 0, '2013-07-05', NULL, NULL, 29.5436, -95.126, NULL, NULL),
('760508619', 'W12027898', 'W12027898', 'TXHOUSTD', 'Texas Gulf Coast Medical Group', '', '', 'Texas Gulf Coast Medical Group', '', 'Clinics', '', '', NULL, 'B', 'PO Box 674029', 'Dallas', 'Dallas', 'TX', '75267', '2816041300', '2817240385', 'PO Box 674029', 'Dallas', 'Dallas', 'TX', '75267', '2816041300', '2817240385', 'GULFCSTMED', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB', '1962512160', 0, 'Y', 0, '2013-05-07', NULL, NULL, 0, 0, NULL, NULL),
('751412851', 'W12027899', 'W12027899', 'TXDALSTD', 'North Texas Family Practice Associates', '', '', 'North Texas Family Practice Assoc', '', 'Family Practice', '', '', NULL, 'O', '7777 Forest Ln C420', 'Dallas', 'Dallas', 'TX', '75230', '9725667976', '9725668164', '7777 Forest Ln C420', 'Dallas', 'Dallas', 'TX', '75230', '9725667976', '9725668164', 'DALLAS1', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811021058', 0, 'Y', 0, '2013-05-08', NULL, NULL, 32.9095, -96.7721, NULL, NULL),
('751412851', 'W12027901', 'W12027901', 'TXDALSTD', 'North Texas Family Practice Associates', 'Robert', 'O', 'Philips', 'MD', 'Family Practice', '', '', NULL, 'O', '7777 Forest Ln C420', 'Dallas', 'Dallas', 'TX', '75230', '9725667976', '9725668164', '7777 Forest Ln C-420', 'Dallas', 'Dallas', 'TX', '75230', '9725667976', '9725668164', 'DALLAS1', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962443044', 0, 'N', 0, '2013-01-02', NULL, NULL, 32.9095, -96.7721, NULL, NULL),
('751412851', 'W12027903', 'W12027903', 'TXDALSTD', 'North Texas Family Practice Associates', 'David', 'L', 'Turner', 'MD', 'Family Practice', '', '', NULL, 'O', '7777 Forest Ln C420', 'Dallas', 'Dallas', 'TX', '75230', '9725667976', '9725668164', '7777 Forest Ln C-420', 'Dallas', 'Dallas', 'TX', '75230', '9725667976', '9725668164', 'DALLAS1', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972544146', 0, 'N', 0, '2013-01-02', NULL, NULL, 32.9095, -96.7721, NULL, NULL),
('751412851', 'W12027905', 'W12027905', 'TXDALSTD', 'North Texas Family Practice Associates', 'Pilar', 'M', 'Bescos', 'MD', 'Family Practice', '', '', NULL, 'O', '7777 Forest Ln C420', 'Dallas', 'Dallas', 'TX', '75230', '9725667976', '9725668164', '7777 Forest Ln C-420', 'Dallas', 'Dallas', 'TX', '75230', '9725667976', '9725668164', 'DALLAS1', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1730127705', 0, 'N', 0, '2013-01-02', NULL, NULL, 32.9095, -96.7721, NULL, NULL),
('751412851', 'W12027907', 'W12027907', 'TXDALSTD', 'North Texas Family Practice Associates', 'Christopher', 'P', 'Kampas', 'MD', 'Family Practice', '', '', NULL, 'O', '7777 Forest Ln C420', 'Dallas', 'Dallas', 'TX', '75230', '9725667976', '9725668164', '7777 Forest Ln C-420', 'Dallas', 'Dallas', 'TX', '75230', '9725667976', '9725668164', 'DALLAS1', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154369536', 0, 'N', 0, '2013-01-02', NULL, NULL, 32.9095, -96.7721, NULL, NULL),
('751412851', 'W12027909', 'W12027909', 'TXDALSTD', 'North Texas Family Practice Associates', 'Bruce', 'E', 'Whitehead', 'MD', 'Family Practice', '', '', NULL, 'O', '7777 Forest Ln C420', 'Dallas', 'Dallas', 'TX', '75230', '9725667976', '9725668164', '7777 Forest Ln C-420', 'Dallas', 'Dallas', 'TX', '75230', '9725667976', '9725668164', 'DALLAS1', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1497796585', 0, 'N', 0, '2013-01-02', NULL, NULL, 32.9095, -96.7721, NULL, NULL),
('760604846', 'W12027911', 'W12027911', 'TXHOUSTD', 'Memorial Pediatrics', '', '', 'Memorial Pediatrics', '', 'Pediatrics', '', '', NULL, 'O', '13630 Beamer Rd Ste 108', 'Houston', 'Harris', 'TX', '77089', '2814846060', '2814846064', '13630 Beamer Rd Ste 108', 'Houston', 'Harris', 'TX', '77089', '2814846060', '2814846064', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114133394', 0, 'Y', 0, '2013-01-09', NULL, NULL, 29.5777, -95.2047, NULL, NULL),
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('202630141', 'W12027988', 'W12027988', 'ID02', 'Primary Health Medical Group', 'Tara', 'C', 'Rothwell', 'PA', 'Family Practice', '', '', NULL, 'O', '5108 E Cleveland Blvd', 'Caldwell', 'Canyon', 'ID', '83607', '2089556500', '2084549690', '5108 E Cleveland Blvd', 'Caldwell', 'Canyon', 'ID', '83607', '2089556500', '2084549690', 'IDSTDPPO', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2013-02-01', '2013-02-28', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1912087438', 0, 'N', 0, '2014-07-08', NULL, NULL, 43.6315, -116.646, NULL, NULL),
('202630141', 'W12027989', 'W12027989', 'ID02', 'Primary Health Medical Group', 'Tara', 'C', 'Rothwell', 'PA', 'Family Practice', '', '', NULL, 'O', '700 Caldwell Blvd', 'Nampa', 'Canyon', 'ID', '83651', '2083451222', '2083451261', '700 Caldwell Blvd', 'Nampa', 'Canyon', 'ID', '83651', '2083451222', '2083451261', 'IDSTDPPO', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2013-02-01', '2013-02-28', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1912087438', 0, 'N', 0, '2014-07-08', NULL, NULL, 43.5968, -116.59, NULL, NULL),
('202630141', 'W12027990', 'W12027990', 'ID02', 'Primary Health Medical Group', 'Tara', 'C', 'Rothwell', 'PA', 'Family Practice', '', '', NULL, 'O', '8971 W Overland', 'Boise', 'Ada', 'ID', '83709', '2083784288', '2083784297', '8971 W Overland', 'Boise', 'Ada', 'ID', '83709', '2083784288', '2083784297', 'IDSTDPPO', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2013-02-01', '2013-02-28', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1912087438', 0, 'N', 0, '2014-07-08', NULL, NULL, 43.5898, -116.294, NULL, NULL),
('870483582', 'W12027992', 'W12027992', 'UT01', 'University of Utah Orthopedic Consultants', '', '', 'University of Utah Orthopedic Consultants', '', 'Orthopedic Surgery', '', '', NULL, 'O', '5848 S Fashion Blvd Ste 120', 'Murray', 'Salt Lake', 'UT', '84107', '8015877028', NULL, '5848 S Fashion Blvd Ste 120', 'Murray', 'Salt Lake', 'UT', '84107', '8015877028', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1487680609', 0, 'N', 0, '2013-02-11', NULL, NULL, 40.6447, -111.883, NULL, NULL),
('870446589', 'W12027993', 'W12027993', 'UT01', 'U-U Alcohol & Drug Clinic School of Medicine', '', '', 'U-U Alcohol & Drug Clinic School of Medicine', 'Group', 'Clinics', '', '', NULL, 'B', 'PO Box 413032', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133900', NULL, 'PO Box 413032', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133900', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1245371699', 0, 'N', 0, '2013-01-02', NULL, NULL, 0, 0, NULL, NULL),
('383881130', 'W12027994', 'W12027994', 'UT01', 'Internal Med Hepatology Department of University of Utah', '', '', 'Internal Med Hepatology Department of University of Utah', '', 'Internal Medicine', '', '', NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015850434', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015850434', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427300177', 0, 'N', 0, '2013-01-02', NULL, NULL, 40.7685, -111.837, NULL, NULL),
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('741889584', 'W12027996', 'W12027996', 'TXHOUSTD', 'KSF Orthopaedic Center', '', '', 'KSF Othopaedic Center', '', 'Orthopedic Surgery', '', '', NULL, 'O', '18220 State Hwy 249 Ste 200', 'Houston', 'Harris', 'TX', '77090', '2814406960', '2814406205', '18220 State Hwy 249 Ste 200', 'Houston', 'Harris', 'TX', '77090', '2814406960', '2814406205', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558343806', 0, 'Y', 0, '2013-01-22', NULL, NULL, 29.9641, -95.5508, NULL, NULL),
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('760512625', 'EDHEA0205', 'EDHEA0205', 'TXHOUSTD', 'Houston Eye Associates', 'Mitchell', 'M', 'Porias', 'MD', 'Ophthalmology', '', '', NULL, 'B', 'PO Box 4958', 'Houston', 'Harris', 'TX', '77210', '7136686828', NULL, 'PO Box 4958', 'Houston', 'Harris', 'TX', '77210', '7136686828', '', 'Houston4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1023147824', 0, 'Y', 0, '2014-06-02', NULL, NULL, 0, 0, NULL, NULL);
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('760512625', 'EDHEA0026', 'EDHEA0026', 'TXHOUSTD', 'Houston Eye Associates', 'Louis', 'E', 'Verstringhe', 'MD', 'Ophthalmology', '', '', NULL, 'O', '13414 Medical Complex Dr Ste 4', 'Tomball', 'Harris', 'TX', '77375', '2813515468', '2813512421', '13414 Medical Complex Dr Ste 4', 'Tomball', 'Harris', 'TX', '77375', '2813515468', '2813512421', 'Houston4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Willowbrook Hospital', NULL, '', NULL, 'HCFA|UB|', '1043429046', 0, 'N', 0, '2013-01-02', NULL, NULL, 30.0846, -95.6233, NULL, NULL),
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('760512625', 'EDHEA0167', 'EDHEA0167', 'TXHOUSTD', 'Houston Eye Associates', 'Louis', 'E', 'Verstringhe', 'MD', 'Ophthalmology', '', '', NULL, 'O', '915 Gessner Ste 250', 'Houston', 'Harris', 'TX', '77024', '7134676474', '7139738679', '915 Gessner Ste 250', 'Houston', 'Harris', 'TX', '77024', '7134676474', '7139738679', 'Houston4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-03-27', 0, 0, 0, 'Houston Methodist Willowbrook Hospital', NULL, '', NULL, 'HCFA|UB|', '1043429046', 0, 'N', 0, '2013-03-27', NULL, NULL, 29.7799, -95.5456, NULL, NULL),
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('760512625', 'EDHEA0152', 'EDHEA0152', 'TXHOUSTD', 'Houston Eye Associates', 'Richard', 'J', 'Ou', 'MD', 'Ophthalmology', '', '', NULL, 'O', '7777 Southwest Fwy Ste 804', 'Houston', 'Harris', 'TX', '77074', '7137776123', '7139881224', '7777 Southwest Fwy Ste 804', 'Houston', 'Harris', 'TX', '77074', '7137776123', '7139881224', 'Houston4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'West Houston Medical Center', NULL, '', NULL, 'HCFA|UB|', '1053319301', 0, 'N', 0, '2013-01-02', NULL, NULL, 29.6947, -95.5234, NULL, NULL),
('760512625', 'EDHEA0166', 'EDHEA0166', 'TXHOUSTD', 'Houston Eye Associates', 'Richard', 'J', 'Ou', 'MD', 'Ophthalmology', '', '', NULL, 'O', '915 Gessner Ste 250', 'Houston', 'Harris', 'TX', '77024', '7134676474', '7139738679', '915 Gessner Ste 250', 'Houston', 'Harris', 'TX', '77024', '7134676474', '7139738679', 'Houston4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'West Houston Medical Center', NULL, '', NULL, 'HCFA|UB|', '1053319301', 0, 'N', 0, '2013-01-02', NULL, NULL, 29.7804, -95.5445, NULL, NULL),
('760512625', 'EDHEA0203', 'EDHEA0203', 'TXHOUSTD', 'Houston Eye Associates', 'Richard', 'J', 'Ou', 'MD', 'Ophthalmology', '', '', NULL, 'B', 'PO Box 4958', 'Houston', 'Harris', 'TX', '77210', '7136686828', NULL, 'PO Box 4958', 'Houston', 'Harris', 'TX', '77210', '7136686828', '', 'Houston4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'West Houston Medical Center', NULL, '', NULL, 'HCFA|UB|', '1053319301', 0, 'Y', 0, '2013-01-02', NULL, NULL, 0, 0, NULL, NULL),
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('760512625', 'EDHEA0215', 'EDHEA0215', 'TXHOUSTD', 'Houston Eye Associates', 'Robert', 'B', 'Wilkins', 'MD', 'Ophthalmology', '', '', NULL, 'B', 'PO Box 4958', 'Houston', 'Harris', 'TX', '77210', '7136686828', NULL, 'PO Box 4958', 'Houston', 'Harris', 'TX', '77210', '7136686828', '', 'Houston4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063407153', 0, 'Y', 0, '2013-01-02', NULL, NULL, 0, 0, NULL, NULL),
('760512625', 'EDHEA0019', 'EDHEA0019', 'TXHOUSTD', 'Houston Eye Associates', 'Fiaz', '', 'Zaman', 'MD', 'Ophthalmology', '', '', NULL, 'O', '1250 Cypress Station Dr Ste A', 'Houston', 'Harris', 'TX', '77090', '2814441677', '2814448631', '1250 Cypress Station Dr Ste A', 'Houston', 'Harris', 'TX', '77090', '2814441677', '2814448631', 'Houston4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073508164', 0, 'N', 0, '2013-01-02', NULL, NULL, 30.0221, -95.438, NULL, NULL),
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('760512625', 'EDHEA0146', 'EDHEA0146', 'TXHOUSTD', 'Houston Eye Associates', 'Fiaz', '', 'Zaman', 'MD', 'Ophthalmology', '', '', NULL, 'M', '7155 Old Katy Rd N100', 'Houston', 'Harris', 'TX', '77024', '7136686828', NULL, '7155 Old Katy Rd N100', 'Houston', 'Harris', 'TX', '77024', '7136686828', '', 'Houston4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073508164', 0, 'Y', 0, '2013-01-02', NULL, NULL, 0, 0, NULL, NULL),
('760512625', 'EDHEA0217', 'EDHEA0217', 'TXHOUSTD', 'Houston Eye Associates', 'Fiaz', '', 'Zaman', 'MD', 'Ophthalmology', '', '', NULL, 'B', 'PO Box 4958', 'Houston', 'Harris', 'TX', '77210', '7136686828', NULL, 'PO Box 4958', 'Houston', 'Harris', 'TX', '77210', '7136686828', '', 'Houston4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073508164', 0, 'Y', 0, '2013-01-02', NULL, NULL, 0, 0, NULL, NULL),
('760512625', 'EDHEA0076', 'EDHEA0076', 'TXHOUSTD', 'Houston Eye Associates', 'Mark', 'C', 'Vital', 'MD', 'Ophthalmology', '', '', NULL, 'O', '2855 Gramercy', 'Houston', 'Harris', 'TX', '77025', '7136686828', '7136683823', '2855 Gramercy', 'Houston', 'Harris', 'TX', '77025', '7136686828', '7136683823', 'Houston4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, '', NULL, 'HCFA|UB|', '1073515912', 0, 'N', 0, '2013-01-02', NULL, NULL, 29.7044, -95.4225, NULL, NULL),
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