Physician Compare National (NPI:1528245701)

HEALTHCARE PROVIDER: ERIC LAWRENCE KRIVITSKY 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	1528245701
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9436286341
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160915000947
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KRIVITSKY
	Individual professional last name
Provider First Name	ERIC
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ADVENTIST PHYSICIAN SERVICES 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	4284631540
	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	66
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	7600 CARROLL AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	UNIT 2100
	Group Practice or individual's line 2 address
City	TAKOMA PARK
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	209126367
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3018917600
	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	210016
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ADVENTIST HEALTHCARE WASHINGTON ADVENTIST HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	210057
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ADVENTIST HEALTHCARE SHADY GROVE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	210060
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	FORT WASHINGTON HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y