Physician Compare National (NPI:1811384530)

HEALTHCARE PROVIDER: ANDREAS KAIKIS DPM

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

Individual Professional Information
NPI	1811384530
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9133452972
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190610001457
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KAIKIS
	Individual professional last name
Provider First Name	ANDREAS
	Individual professional first name
Provider Middle Name	CHRISOVALANTIS
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2015
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	MCDUFFIE PODIATRY AND WOUND CARE, 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	1355237819
	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	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	544 W HILL ST
	Group Practice or individual's line 1 address
City	THOMASON
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	308242117
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7065958787
	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	110111
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	111325
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	WILLS MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	110100
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	JEFFERSON HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	110028
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	UNIVERSITY HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y