Individual provider Active NPI

Donald W Kucharzyk, D.O.

  • Pediatric Orthopaedic Surgery Physician
  • Crown Point, IN
National Provider Identifier
1164499505
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
02001091A Issued in IN
Practice address
7284 W Lincoln Hwy
Crown Point, IN 46307-9526
Phone
(219) 769-7004
Fax
(219) 440-7188
NPI assigned
Mar 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 02001091A IN
Orthopaedic Surgery of the Spine Physician 207XS0117X 02001091A IN
Pediatric Orthopaedic Surgery Physician 207XP3100X 02001091A IN Primary

Addresses

Primary practice location

7284 W Lincoln Hwy
Crown Point, IN 46307-9526

Mailing address

7284 W Lincoln Hwy
Crown Point, IN 46307-9526
Phone (219) 769-7004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20080714000160 IN Practitioner - Orthopedic Surgery 2062409089 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02001091AINMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Healthcare, LLC CurrentSince Mar 6, 2017 Accepting new patients

Locations

9301 Connecticut Dr
Crown Point, IN 46307
Phone (219) 756-2100

8550 Broadway
Merrillville, IN 46410
Phone (219) 736-8888

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1164499505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7284 W LINCOLN HWY",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463079526",
            "telephone_number": "219-769-7004",
            "fax_number": "219-440-7188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7284 W LINCOLN HWY",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463079526",
            "telephone_number": "219-769-7004",
            "fax_number": "219-440-7188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCHARZYK",
        "first_name": "DONALD",
        "middle_name": "W",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "02001091A",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "IN",
            "license": "02001091A",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "IN",
            "license": "02001091A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.