Physician Compare National (NPI:1356405559)

HEALTHCARE PROVIDER: NELSON KRAUCAK M.D.

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

Individual Professional Information
NPI	1356405559
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4688567605
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20081117000824
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KRAUCAK
	Individual professional last name
Provider First Name	NELSON
	Individual professional first 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	1987
	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
Line 1 Street Address	1501 N US HWY 441
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1704
	Group Practice or individual's line 2 address
City	THE VILLAGES
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	321596802
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100290
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	VILLAGES REGIONAL HOSPITAL, THE
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y