Physician Compare National (NPI:1720078298)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1720078298
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0941108013
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20031229000124
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	VENGLARCIK
	Individual professional last name
Provider First Name	JOHN
	Individual professional first name
Provider Middle Name	S
	Individual professional middle name
Provider Name Suffix Text	III
	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.
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	OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1977
	Individual professional's medical school graduation year
Primary Specialty	INFECTIOUS DISEASE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PEDIATRIC MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PEDIATRIC MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	819 MCKAY CT
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE B3
	Group Practice or individual's line 2 address
City	YOUNGSTOWN
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	445125771
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y