Individual provider Active NPI

Michael Walter Kaczmarski, M.D.

  • Anesthesiology Physician
  • Hoffman Estates, IL
National Provider Identifier
1336415538
Registry record updated Feb 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036143397 Issued in IL
Practice address
1555 Barrington Rd
Hoffman Estates, IL 60169
Phone
(847) 843-2000
NPI assigned
Apr 1, 2012
Last updated
Feb 15, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036143397 IL Primary

Addresses

Primary practice location

1555 Barrington Rd
Hoffman Estates, IL 60169

Mailing address

PO Box 3613
Carol Stream, IL 60132-3613

Other practice location 1

1611 NW 12th Ave
Miami, FL 33136-1005
Phone (305) 585-6970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20201026002863 FL Practitioner - Anesthesiology 5597030619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Indiana University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Nemours FoundationGroup PAC ID 9537072483, 249 clinicians

Practice addresses (Care Compare)

6535 Nemours Pkwy
Orlando, FL 32827-7884
Phone (407) 567-4000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Sep 4, 2020 Accepting new patients
The Nemours Foundation Current Accepting new patients
The Nemours Foundation CurrentSince Sep 4, 2020 Accepting new patients

Locations

10140 Centurion Pkwy N
Jacksonville, FL 32256
Phone (904) 697-4100

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

6535 Nemours Pkwy
Orlando, FL 32827
Phone (407) 567-4000

Organizations & group practices 3

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": "1333238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1336415538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3613",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601323613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 BARRINGTON RD",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "60169",
            "telephone_number": "847-843-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 NW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361005",
            "country_code": "US",
            "telephone_number": "305-585-6970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KACZMARSKI",
        "first_name": "MICHAEL",
        "middle_name": "WALTER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-01",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036143397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

Verify at the official NPI Registry.