Edidiong Kaminska, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036.133070 Issued in IL

Practice address

3808 N Lincoln Ave
Ste 101
Chicago, IL 60613-6065

Phone

(773) 677-4300

NPI assigned

Jun 17, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Dermatology

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kaminska Dermatology PLLCGroup PAC ID 2860723285, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ekaminska202591@direct.cshs.org
• FHIR API: https://app.meldrx.com/api/fhir/ez_00174

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.

• Kaminska Dermatology PLLC

  • Dermatology Physician
  • Chicago, IL
  • NPI 1265073415
  Medicare reassignment Care Compare group NPD Authorized official
• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  Dermatology

  Medicare reassignment NPD
• Kaminska Dermatology

  • Dermatology Physician
  • Chicago, IL
  • NPI 1093377731
  NPD (past) Authorized official
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1407083496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 N ASHLAND AVE UNIT 577452",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577783",
            "telephone_number": "901-907-9820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 N LINCOLN AVE",
            "address_2": "STE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606136065",
            "telephone_number": "773-677-4300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 E Erie St Ste 530",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112792",
            "country_code": "US",
            "telephone_number": "773-677-4300",
            "fax_number": "773-423-8429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMINSKA",
        "first_name": "EDIDIONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "136349",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036.133070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATIONAL NPI",
            "identifier": "1265073415",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.kaminskadermatology.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3000 N Halsted St Ste 724",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606575196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle Kamin-Lindsay, LCSW
• Kelsey Kamin
• Maryn Kamin, FNP
• Kaminska Dermatology
• Kaminska Dermatology PLLC
• Brittany Kaminski, PT, DPT
• Chris Kaminski, PT, DPT
• Jan Pawel Kaminski, MD
• Kevin Kaminski
• Lauren Kaminski

• Dermatology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.

Verify at the official NPI Registry.