Physician Compare National (NPI:1346259512)

HEALTHCARE PROVIDER: NADIA VALERY KOVALCHUK MD

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

Individual Professional Information
NPI	1346259512
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2163695040
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190814001119
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KOVALCHUK
	Individual professional last name
Provider First Name	NADIA
	Individual professional first name
Provider Middle Name	VALERY
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1991
	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	SINAI HOSPITAL OF BALTIMORE, INC
	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	0941112346
	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	315
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2401 W BELVEDERE AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	HOSPITALIST OFFICE
	Group Practice or individual's line 2 address
City	BALTIMORE
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	212155216
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4106010594
	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	210012
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SINAI HOSPITAL OF BALTIMORE
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	210004
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HOLY CROSS HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y