Active NPI
Anthony Thomas Kaczmarek, M.D.
- Specialist
- Rolla, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 10031
- Practice address
- 1428 East 72Highway
Rolla, MO 65401 - Phone
- (573) 364-1014
- Fax
- (573) 364-6872
- NPI assigned
- Apr 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 110031 | MO | |
| Specialist | 174400000X | 10031 | MO | Primary |
Addresses
Primary practice location
1428 East 72Highway
Rolla, MO 65401
Mailing address
1050 W 10TH St
Rolla, MO 65401-2905
Phone (573) 364-1014
Other practice location 1
1428 E State Highway 72
Rolla, MO 65401-3988
Phone (573) 364-1014
Other practice location 2
1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 458-8899
Other practice location 3
1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 364-9000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 208305102 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- University of Missouri, Columbia School of Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1428 E State Hwy 72
Pcrmc Medical Group Inc
Rolla, MO 65401-3988
Phone (573) 364-1014
Hospital & facility affiliations
- Phelps County Regional Medical Center
- Salem Memorial District Hospital
- Texas County Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 1-10 |
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10031 | MO | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pcrmc Medical Group, Inc | Current | Accepting new patients | |
| Central Missouri Urology Clinic, Inc | Specialist | Current | Accepting new patients |
| Phelps County Regional Medical Center | Current | Accepting new patients | |
| Phelps County Regional Medical Center | Current | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
1428 E State Route 72
Rolla, MO 65401
Phone (573) 364-1014
1050 W 10th St
Rolla, MO 65401
Phone (573) 364-9000
1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000
Interoperability endpoints
- https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/73329
Organizations & group practices 5
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.
-
- Clinic/Center
- Rolla, MO
- NPI 1124237227
-
- General Acute Care Hospital
- Rolla, MO
- NPI 1891766051
-
- Specialist
- Rolla, MO
- NPI 1710940630
-
- Rural Health Clinic/Center
- Rolla, MO
- NPI 1366066037
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- Rolla, MO
- NPI 1346287455
-
- General Acute Care Hospital
- Rolla, MO
- NPI 1891766051
-
- Medicare Defined Swing Bed Hospital Unit
- Salem, MO
- NPI 1134199417
-
- Critical Access Hospital
- Salem, MO
- NPI 1639177561
-
- Medicare Defined Swing Bed Hospital Unit
- Houston, MO
- NPI 1023179298
-
- General Acute Care Hospital
- Houston, MO
- NPI 1790740363
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772409600000",
"number": "1306803754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 W 10TH ST",
"city": "ROLLA",
"state": "MO",
"postal_code": "654012905",
"telephone_number": "573-364-1014",
"fax_number": "573-364-6872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1428 EAST 72HIGHWAY",
"city": "ROLLA",
"state": "MO",
"postal_code": "65401",
"telephone_number": "573-364-1014",
"fax_number": "573-364-6872"
}
],
"practiceLocations": [
{
"address_1": "1428 E State Highway 72",
"address_purpose": "LOCATION",
"city": "Rolla",
"state": "MO",
"postal_code": "654013988",
"country_code": "US",
"telephone_number": "573-364-1014",
"fax_number": "573-364-6872",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1000 W 10th St",
"address_purpose": "LOCATION",
"city": "Rolla",
"state": "MO",
"postal_code": "654012905",
"country_code": "US",
"telephone_number": "573-458-8899",
"fax_number": "573-341-5611",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1000 W 10th St",
"address_purpose": "LOCATION",
"city": "Rolla",
"state": "MO",
"postal_code": "654012905",
"country_code": "US",
"telephone_number": "573-364-9000",
"fax_number": "573-426-2108",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KACZMAREK",
"first_name": "ANTHONY",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-28",
"last_updated": "2026-03-02",
"certification_date": "2026-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "MO",
"license": "110031",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MO",
"license": "10031",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "208305102",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rolla, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.