Physician Compare National (NPI:1003011966)

HEALTHCARE PROVIDER: AARON DANIEL KALLSNICK M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1003011966
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3577656487
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150820011577
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KALLSNICK
	Individual professional last name
Provider First Name	AARON
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2003
	Individual professional's medical school graduation year
Primary Specialty	ANESTHESIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	RACINE ANESTHESIA SERVICES, LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8628103777
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	29
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3801 SPRING ST
	Group Practice or individual's line 1 address
City	MOUNT PLEASANT
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	534051667
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2626874392
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	520096
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WHEATON FRANCISCAN HEALTHCARE ALL SAINTS
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y