Physician Compare National (NPI:1407868706)

HEALTHCARE PROVIDER: EFTHIMIOS ALEXANDER BAKALAKOS 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	1407868706
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2163583162
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101122000336
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BAKALAKOS
	Individual professional last name
Provider First Name	EFTHIMIOS
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
	Individual professional's medical school
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	EMERGENCY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	EMERGENCY MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	SANFORD HEALTH NETWORK
	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	6800707100
	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	209
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	249 5TH ST E
	Group Practice or individual's line 1 address
Line 2 Street Address	SANFORD TRACY HOSPITAL
	Group Practice or individual's line 2 address
City	TRACY
	Group Practice or individual's city
State	MN
	Group Practice or individual's state
Zip Code	561751536
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5076293520
	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	241347
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SANFORD CANBY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	241303
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SANFORD TRACY
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	431307
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SANFORD CLEAR LAKE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	241302
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	SANFORD WESTBROOK MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y