Physician Compare National (NPI:1033352448)

HEALTHCARE PROVIDER: NICHOLAS SAKELLARIOS 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	1033352448
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3274799341
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120718000680
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SAKELLARIOS
	Individual professional last name
Provider First Name	NICHOLAS
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

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	2009
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	RAJESWARA RAO PATCHA MD PC
	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	9638068323
	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	10
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	325 MAIN ST
	Group Practice or individual's line 1 address
City	NORTHPORT
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	117681790
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6313850022
	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	100087
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SARASOTA MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y