Physician Compare National (NPI:1811900368)

HEALTHCARE PROVIDER: JOHN BEACOM MD

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

Individual Professional Information
NPI	1811900368
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3375676158
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100730000091
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BEACOM
	Individual professional last name
Provider First Name	JOHN
	Individual professional first name
Provider Middle Name	P
	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 NEBRASKA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1993
	Individual professional's medical school graduation year
Primary Specialty	ANESTHESIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERVENTIONAL PAIN MANAGEMENT
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	PAIN MANAGEMENT
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERVENTIONAL PAIN MANAGEMENT, PAIN MANAGEMENT
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	SWEDISH COVENANT MANAGEMENT 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	4486556016
	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	191
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	5140 N CALIFORNIA AVE
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	CHICAGO
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	606257066
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140114
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SWEDISH COVENANT HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y