Physician Compare National (NPI:1003805656)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1003805656
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4880769454
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080815000326
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	JARECKI
	Individual professional last name
Provider First Name	STEVEN
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK CHIROPRACTIC COLLEGE
	Individual professional's medical school
Graduation Year	1987
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	220 CONGRESS PARK DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 110
	Group Practice or individual's line 2 address
City	DELRAY BEACH
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	334454605
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y