Physician Compare National (NPI:1063491397)

HEALTHCARE PROVIDER: DEMETRIUS PETER RIZOS 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	1063491397
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0648379180
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070623000067
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RIZOS
	Individual professional last name
Provider First Name	DEMETRIUS
	Individual professional first name
Provider Middle Name	P
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1998
	Individual professional's medical school graduation year
Primary Specialty	HOSPITALIST
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ANNA JAQUES INPATIENT SPECIALISTS PLLC
	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	3476836263
	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	11
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	25 HIGHLAND AVE
	Group Practice or individual's line 1 address
City	NEWBURYPORT
	Group Practice or individual's city
State	MA
	Group Practice or individual's state
Zip Code	019503867
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9786852460
	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	220029
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ANNA JAQUES HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	301310
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ANDROSCOGGIN VALLEY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	220080
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HOLY FAMILY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	330385
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	NORTH CENTRAL BRONX HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y