Physician Compare National (NPI:1487051371)

HEALTHCARE PROVIDER: JACOB VALABOV DPM

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

Individual Professional Information
NPI	1487051371
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0547551137
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160629002109
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	VALABOV
	Individual professional last name
Provider First Name	JACOB
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WILLIAM M. SCHOLL COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	PREFERRED PODIATRY GROUP PC
	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	3971412677
	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	93
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	112 PEACE LUTHERAN PKWY
	Group Practice or individual's line 1 address
City	HARTFORD
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	530271159
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2623978790
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y