Individual provider Active NPI

Christopher J Kaczmarski, M.D.

  • Surgery Physician
  • Nyack, NY
National Provider Identifier
1205866225
Registry record updated Jan 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
148896 Issued in NY
Practice address
160 N Midland Ave FL 2
Nyack, NY 10960-1912
Phone
(845) 348-7600
Fax
(845) 348-2536
NPI assigned
Jul 4, 2006
Last updated
Jan 28, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD063400L PA
Surgery Physician 208600000X 148896 NY Primary

Addresses

Primary practice location

160 N Midland Ave FL 2
Nyack, NY 10960-1912

Mailing address

305 Orchard Ave
Langhorne, PA 19047-3159
Phone (609) 760-3014

Other identifiers 2

IdentifierTypeStateIssuer
J400523903OtherNYMEDICARE
01231790MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
White Plains Medical Diagnostic Services, PC Family Medicine CurrentSince Oct 1, 2022 Accepting new patients
Pma Medical Specialists Family Medicine Past Accepting new patients
Collin Em Brathwaite MD PLLC Surgery Past Accepting new patients
Bariatric Specialists of Pennsylvania, P.C. Surgery Past Accepting new patients
Major Hospital Past Accepting new patients
Center for Vein Restoration CT LLC Past Accepting new patients
Suffolk Surgical Group, PC Surgery Past Accepting new patients

Locations

160 N Midland Ave
Fl 2
Nyack, NY 10960
Phone (845) 348-7600

Interoperability endpoints

  • Direct secure messaging: christopher.kaczmarskimd.p3@direct.cvr.nextgenshare.com
  • Direct secure messaging: christopher.kaczmarskimd.p5@direct.cvr.nextgenshare.com

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1205866225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 ORCHARD AVE",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190473159",
            "telephone_number": "609-760-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 N MIDLAND AVE FL 2",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109601912",
            "telephone_number": "845-348-7600",
            "fax_number": "845-348-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZMARSKI",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD063400L",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "148896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "J400523903",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01231790",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nyack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.