Individual provider Active NPI

Mateusz Tkacz, MD

  • Pulmonary Disease Physician
  • Chapel Hill, NC
National Provider Identifier
1033799713
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
2025-01748 Issued in NC
Practice address
CB# 7020, 130 Mason Farm Road
4TH Floor Bioinformatics Building
Chapel Hill, NC 27599-7020
Phone
(919) 966-2531
NPI assigned
Apr 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 2025-01748 NC
Hospitalist Physician 208M00000X 036170685 IL
Pulmonary Disease Physician 207RP1001X 2025-01748 NC Primary

Addresses

Primary practice location

CB# 7020, 130 Mason Farm Road
4TH Floor Bioinformatics Building
Chapel Hill, NC 27599-7020

Mailing address

CB# 7020, 130 Mason Farm Road
4TH Floor Bioinformatics Building
Chapel Hill, NC 27599-7020
Phone (919) 966-2531

Other practice location 1

600 S Paulina St Ste 403
Chicago, IL 60612-3806
Phone (312) 942-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210825003731 IL Order and Referring Only - Internal MedicinePractitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 1557766706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1033799713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CB# 7020, 130 MASON FARM ROAD",
            "address_2": "4TH FLOOR BIOINFORMATICS BUILDING",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997020",
            "telephone_number": "919-966-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CB# 7020, 130 MASON FARM ROAD",
            "address_2": "4TH FLOOR BIOINFORMATICS BUILDING",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997020",
            "telephone_number": "919-966-2531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 S Paulina St Ste 403",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123806",
            "country_code": "US",
            "telephone_number": "312-942-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TKACZ",
        "first_name": "MATEUSZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-08",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NC",
            "license": "2025-01748",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036170685",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": "2025-01748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.