NPIMap

Individual provider Active NPI

Theodore Kaczmar Jr., MD

  • Neurological Surgery Physician
  • Salinas, CA
National Provider Identifier
1265449136
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
G546380 Issued in CA
Practice address
220 San Jose St
Salinas, CA 93901-3901
Phone
(831) 424-0807
Fax
(831) 424-3408
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X G546380 CA Primary

Addresses

Primary practice location

220 San Jose St
Salinas, CA 93901-3901

Mailing address

1033 Los Palos Dr
Salinas, CA 93901-3916
Phone (831) 757-2058

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ70373ZMedicaidCA
94170316793901A002OtherTRICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041222000220 CA Practitioner - Neurosurgery 0941268940 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Washington University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Svmhs ClinicsGroup PAC ID 1456592351, 258 clinicians

Practice addresses (Care Compare)

1033 Los Palos Dr
Salinas, CA 93901-3916
Phone (831) 757-2058

Hospital & facility affiliations

  • Salinas Valley Health Medical Center Hospital, Salinas, CA, CCN 050334
  • Community Hospital of the Monterey Peninsula Hospital, Monterey, CA, CCN 050145

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion18
Laminectomy or laminotomy (partial removal of spine bones)12
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G546380CAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Svmhs Clinics CurrentSince Apr 1, 2019 Accepting new patients
Svmhs Clinics CurrentSince Apr 1, 2019 Accepting new patients
Community Hospital of the Monterey Peninsula Past Accepting new patients
Montage Surgical Group Neurological Surgery Past Accepting new patients
Central Coast Brain and Spine Associates a Medical Corporation Neurological Surgery Past Accepting new patients
Salinas Valley Memorial Healthcare System Past Accepting new patients
Lancelot O Alexander MD a Medical Corporation Past Accepting new patients

Locations

100 Wilson Rd
Ste 100
Monterey, CA 93940
Phone (831) 242-8301

611 Abbott St
Ste 101
Salinas, CA 93901
Phone (831) 676-3573

1033 Los Palos Dr
Salinas, CA 93901
Phone (831) 424-2866

Interoperability endpoints

  • Direct secure messaging: tkaczmar11508@direct.svmh.com

Organizations & group practices 8

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1265449136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 LOS PALOS DR",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939013916",
            "telephone_number": "831-757-2058",
            "fax_number": "831-757-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SAN JOSE ST",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939013901",
            "telephone_number": "831-424-0807",
            "fax_number": "831-424-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZMAR",
        "first_name": "THEODORE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "G546380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ70373Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "94170316793901A002",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salinas, CA

Sources for this page

Verify at the official NPI Registry.