Physician Compare National (NPI:1457311375)

HEALTHCARE PROVIDER: JOHN A STATHOS JR. 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	1457311375
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3072622935
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101108000526
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	STATHOS
	Individual professional last name
Provider First Name	JOHN
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	OPHTHALMOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2010 N AUGUSTA ST
	Group Practice or individual's line 1 address
City	STAUNTON
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	244012435
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	490018
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	AUGUSTA HEALTH
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y