Raymond L Kacich, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

036-086191 Issued in IL

Practice address

3601 S 6TH Ave # 1-11C
Tucson, AZ 85723-5104

Phone

(520) 429-2580

Fax

(520) 629-4976

NPI assigned

Oct 19, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Prairie Cardiovascular Consultants LTD

  • Cardiovascular Disease Physician
  • Springfield, IL
  • NPI 1659539559

  Specialist

  NPD (past)
• Prairie Cardiovascular Consultants LTD

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1982714218

  Cardiovascular Disease

  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1427130772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 S 6TH AVE # 1-11C",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857230001",
            "telephone_number": "520-429-2580",
            "fax_number": "520-629-4976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 S 6TH AVE # 1-11C",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857235104",
            "telephone_number": "520-429-2580",
            "fax_number": "520-629-4976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 E Carpenter St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627025104",
            "country_code": "US",
            "telephone_number": "217-788-0706",
            "fax_number": "217-523-4520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KACICH",
        "first_name": "RAYMOND",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-086191",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036-086191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086191",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "060021806",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• K.D. Keel PLLC
• Keith Ross Kaback, MD
• Caroline M. Kacer, DMD
• Kurtis Andrew Kacer, D.M.D., M.S.
• Diana Kachan, MD, PHD
• Anya Lauren Kaczmarek, PA-C
• Michelle Ann Kaczynski, PHARM D
• Stephen Stanley Kaczynski, D.O.
• Firas Kaddouh, M.D.
• Lindsay Kadell, DO

• Cardiovascular Disease Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Cardiovascular Disease Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.