Physician Compare National (NPI:1972661296)

HEALTHCARE PROVIDER: JAROSLAW J KOTLARCZYK M.D.

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

Individual Professional Information
NPI	1972661296
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9830080738
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080430000698
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KOTLARCZYK
	Individual professional last name
Provider First Name	JAROSLAW
	Individual professional first 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	1991
	Individual professional's medical school graduation year
Primary Specialty	ANESTHESIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1211 24TH ST
	Group Practice or individual's line 1 address
City	ANACORTES
	Group Practice or individual's city
State	WA
	Group Practice or individual's state
Zip Code	982212562
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3605888457
	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	500007
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ISLAND HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y