Physician Compare National (NPI:1609841188)

HEALTHCARE PROVIDER: MARY FREKKO KILAVOS 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	1609841188
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8325069743
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20051213000854
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KILAVOS
	Individual professional last name
Provider First Name	MARY
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	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	GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2002
	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	JOHNS HOPKINS COMMUNITY PHYSICIANS
	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	8325943707
	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	534
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	14955 SHADY GROVE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	100 JHCP MONTGOMERY GROVE
	Group Practice or individual's line 2 address
City	ROCKVILLE
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	208508728
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3019903190
	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	210022
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SUBURBAN HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	090005
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SIBLEY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y