Physician Compare National (NPI:1275796658)

HEALTHCARE PROVIDER: JOHN VICTOR JAKOVICH 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	1275796658
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1759538994
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120823000464
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	JAKOVICH
	Individual professional last name
Provider First Name	JOHN
	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	LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL MEDICINE AND REHABILITATION
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERVENTIONAL PAIN MANAGEMENT
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	OSTEOPATHIC MANIPULATIVE MEDICINE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERVENTIONAL PAIN MANAGEMENT, OSTEOPATHIC MANIPULATIVE MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	MAYO CLINIC HEALTH SYSTEM SOUTHWEST MINNESOTA REGION
	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	4688585771
	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	527
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1025 MARSH ST
	Group Practice or individual's line 1 address
City	MANKATO
	Group Practice or individual's city
State	MN
	Group Practice or individual's state
Zip Code	560014752
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5076254031
	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	240093
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MAYO CLINIC HEALTH SYSTEM - MANKATO
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y