Physician Compare National (NPI:1962498527)

HEALTHCARE PROVIDER: JOSEPH RANDY KALIK 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	1962498527
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8527234863
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120109000090
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KALIK
	Individual professional last name
Provider First Name	JOSEPH
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	COLLEGE OF PHYSICIANS AND SURGEONS (IOWA)
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	295 N KERRWOOD DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 101
	Group Practice or individual's line 2 address
City	HERMITAGE
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	161485207
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7243475507
	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	390211
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SHARON REGIONAL HEALTH SYSTEM
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	390178
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	UPMC HORIZON
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y