Physician Compare National (NPI:1003952458)

HEALTHCARE PROVIDER: ELDAD SHAUL BIALECKI 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	1003952458
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0749360584
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080105000010
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BIALECKI
	Individual professional last name
Provider First Name	ELDAD
	Individual professional first name
Provider Middle Name	S
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Primary Specialty	GASTROENTEROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	AMERICAN MULTISPECIALTY GROUP INC
	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	1658365572
	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	153
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	100 VILLAGE SQUARE SHOP CTR
	Group Practice or individual's line 1 address
City	HAZELWOOD
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	630421820
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3143554010
	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	260104
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SSM DEPAUL HEALTH CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	260180
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CHRISTIAN HOSPITAL NORTHEAST
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y