Jill Kaczmarek, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F333250 Issued in NY

Practice address

4711 Transit Rd
Lancaster, NY 14043-4888

Phone

(716) 668-5331

Fax

(716) 668-5370

NPI assigned

Dec 29, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orchard Park Family Practice, PCGroup PAC ID 7517937261, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jillkaczmarek@opfp.medentdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Orchard Park Family Practice, PC

  • Family Medicine Physician
  • Orchard Park, NY
  • NPI 1811000979
  Medicare reassignment Care Compare group NPD
• Forestream Pediatrics, LLP

  • Pediatric Adolescent Medicine Physician
  • Depew, NY
  • NPI 1407813058
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405900800000",
    "number": "1023095098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 TRANSIT RD",
            "city": "LANCASTER",
            "state": "NY",
            "postal_code": "140434888",
            "telephone_number": "716-668-5331",
            "fax_number": "716-668-5370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 TRANSIT RD",
            "city": "LANCASTER",
            "state": "NY",
            "postal_code": "140434888",
            "telephone_number": "716-668-5331",
            "fax_number": "716-668-5370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZMAREK",
        "first_name": "JILL",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2014-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F333250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000560626003",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "9511960",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00026518302",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02343424",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruth Johnson, LMHC
• Jennifer Jones, RD
• JT Bagen Enterprises Inc
• Janelle Juda
• Christopher Michael Kacalski, DDS
• Nicholas David Kagelmacher
• Larry Frank Kajfasz, PHARM.D
• Renee Ann Keeton, CASAC
• Adam Dean Kehrer, M.S., C.A.S.
• Carol M King, R.N.

• Nurse Practitioner in Lancaster, NY
• Providers in Lancaster, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.