Physician Compare National (NPI:1811017833)

HEALTHCARE PROVIDER: DONNA M KALENDERIAN NP

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

Individual Professional Information
NPI	1811017833
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2163672452
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20121023000116
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KALENDERIAN
	Individual professional last name
Provider First Name	DONNA
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1992
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	PECONIC CARDIOLOGY PC
	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	0143568717
	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	11
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1300 ROANOKE AVE
	Group Practice or individual's line 1 address
City	RIVERHEAD
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	119012031
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6315486000
	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	330107
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PECONIC BAY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330393
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SUNY/STONY BROOK UNIVERSITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y