Physician Compare National (NPI:1013007046)

HEALTHCARE PROVIDER: THOMAS JOHN SHEWCZYK MD

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

Individual Professional Information
NPI	1013007046
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8527229806
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120412000687
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SHEWCZYK
	Individual professional last name
Provider First Name	THOMAS
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1974
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4922 COLUMBIA RD
	Group Practice or individual's line 1 address
City	CEDARBURG
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	530129188
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	520027
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	COLUMBIA ST MARYS HOSPITAL OZAUKEE
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y