Physician Compare National (NPI:1932373552)

HEALTHCARE PROVIDER: JOHN J. PODKOWA JR. D.O.

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

Individual Professional Information
NPI	1932373552
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0547323925
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20091013000186
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PODKOWA
	Individual professional last name
Provider First Name	JOHN
	Individual professional first name
Provider Name Suffix Text	JR.
	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.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2005
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	HOSPITALIST
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	PEDIATRIC MEDICINE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	HOSPITALIST, PEDIATRIC MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	SOUTHCOAST PHYSICIANS GROUP, 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	0749171957
	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	537
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	208 MILL RD
	Group Practice or individual's line 1 address
City	FAIRHAVEN
	Group Practice or individual's city
State	MA
	Group Practice or individual's state
Zip Code	027195208
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5089732432
	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	220074
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SOUTHCOAST HOSPITALS GROUP
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y