Physician Compare National (NPI:1497732598)

HEALTHCARE PROVIDER: JESSE JOSEPH STAWICKI D.O.

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

Individual Professional Information
NPI	1497732598
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5496790073
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050623000764
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	STAWICKI
	Individual professional last name
Provider First Name	JESSE
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	DO
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	UNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE
	Individual professional's medical school
Graduation Year	1983
	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	STAWICKI AND PATNAIK MEDICAL ASSOCIATES, P.C.
	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	7012963184
	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	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1235 WHITEHORSE MERCERVILLE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 316C
	Group Practice or individual's line 2 address
City	MERCERVILLE
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	086193810
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6095815586
	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	310110
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT HAMILTON
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	310021
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SAINT FRANCIS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y