Individual provider Active NPI

Casimir Czarnecki, MD

  • Ophthalmology Physician
  • Philadelphia, PA
National Provider Identifier
1154407294
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD028579L Issued in PA
Practice address
9412 Academy Rd
Philadelphia, PA 19114
Phone
(215) 676-2242
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD028579L PA Primary

Addresses

Primary practice location

9412 Academy Rd
Philadelphia, PA 19114

Mailing address

9412 Academy Rd
Philadelphia, PA 19114
Phone (215) 676-2242

Other identifiers 1

IdentifierTypeStateIssuer
000735917001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100726000449 PA Practitioner - Ophthalmology 0446382527 Practice locations: Philadelphia, PA

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DRS C and D Czarnecki PA Ophthalmology Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202083200000",
    "number": "1154407294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9412 ACADEMY RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19114",
            "telephone_number": "215-676-2242",
            "fax_number": "215-676-4938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9412 ACADEMY RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19114",
            "telephone_number": "215-676-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZARNECKI",
        "first_name": "CASIMIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2008-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD028579L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000735917001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.