Physician Compare National (NPI:1043486285)

HEALTHCARE PROVIDER: DMITRY V SHMERKOVICH DO

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

Individual Professional Information
NPI	1043486285
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1254503709
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111006000136
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SHMERKOVICH
	Individual professional last name
Provider First Name	DMITRY
	Individual professional first name
Provider Middle Name	V
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MIDWESTERN UNIVERSITY COLLEGE OF DENTAL MEDICINE, GLENDALE
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	NEUROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PSYCHIATRY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PSYCHIATRY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	55 GREEN ST
	Group Practice or individual's line 1 address
City	BROOKLYN
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	112225831
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	330196
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NYC HEALTH + HOSPITALS/CONEY ISLAND
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330055
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	NEW YORK-PRESBYTERIAN/QUEENS
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	330056
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	BROOKLYN HOSPITAL CENTER AT DOWNTOWN CAMPUS
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y