Physician Compare National (NPI:1023066065)

HEALTHCARE PROVIDER: MATTHEW ANTALEK D.O.

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

Individual Professional Information
NPI	1023066065
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8820033228
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20061031000392
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ANTALEK
	Individual professional last name
Provider First Name	MATTHEW
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	DO
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
	Individual professional's medical school
Graduation Year	1985
	Individual professional's medical school graduation year
Primary Specialty	INFECTIOUS DISEASE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	INTERNAL MED ID ASSOCIATES, 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	3577508969
	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	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2235 MILLERSPORT HWY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	GETZVILLE
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	140681219
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7162045933
	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	330005
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	KALEIDA HEALTH
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330279
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MERCY HOSPITAL OF BUFFALO
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	330078
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SISTERS OF CHARITY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y