Physician Compare National (NPI:1528021813)

HEALTHCARE PROVIDER: THEODORE ARTHUR CALIANOS II 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	1528021813
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4284737891
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110426000192
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CALIANOS
	Individual professional last name
Provider First Name	THEODORE
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Name Suffix Text	II
	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 TEXAS MEDICAL BRANCH AT GALVESTON
	Individual professional's medical school
Graduation Year	1991
	Individual professional's medical school graduation year
Primary Specialty	PLASTIC AND RECONSTRUCTIVE SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	MEDICAL AFFILIATES OF CAPE COD, INC.
	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	3577471564
	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	76
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	160 FALMOUTH RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE B
	Group Practice or individual's line 2 address
City	MASHPEE
	Group Practice or individual's city
State	MA
	Group Practice or individual's state
Zip Code	026492652
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5085396220
	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	220135
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	FALMOUTH HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	220012
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CAPE COD HEALTHCARE
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y