Kimberly Kaczmarek, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50.004653RX Issued in OH

Practice address

4405 N Holland Sylvania Rd
Toledo, OH 43623-3529

Phone

(419) 517-0146

NPI assigned

Apr 4, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Greater Toledo Urgent Cares, LLC.

  • Emergency Medicine Physician
  • Toledo, OH
  • NPI 1982993010
  NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1083077218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 N HOLLAND SYLVANIA RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233529",
            "telephone_number": "419-517-0146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 N HOLLAND SYLVANIA RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233529",
            "telephone_number": "419-517-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZMAREK",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.004653RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Huda Kaake, LPC
• Haidar Kabbani, M.D.
• Nour Kablaoui, AA
• Jean Jayelle Kabo
• James Kaczmarek, QMHS
• Matthew Kaczynski, QMHS
• Abdullah Kadan, MD
• Niyati Ketan Kadia
• Sohrab Christopher Kadivar, MD
• Helbert Kadmih

• Medical Physician Assistant in Toledo, OH
• Providers in Toledo, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.