Physician Compare National (NPI:1114949179)

HEALTHCARE PROVIDER: CONSTANTINE PAUL PANAKOS 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	1114949179
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4688656580
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040603001326
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PANAKOS
	Individual professional last name
Provider First Name	CONSTANTINE
	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.
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	KANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED
	Individual professional's medical school
Graduation Year	2001
	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
Organization Legal Name	TANGLEWOOD FAMILY MEDICAL CENTER PA
	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	7113911389
	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	8
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	606 MULBERRY RD
	Group Practice or individual's line 1 address
City	DERBY
	Group Practice or individual's city
State	KS
	Group Practice or individual's state
Zip Code	670373532
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3167883787
	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	170123
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WESLEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y