Individual provider Active NPI

Rachel Ellen Kaczynski, D.O.

  • Surgical Oncology Physician
  • San Antonio, TX
National Provider Identifier
1487942736
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
T2191 Issued in TX
Practice address
2130 NE Loop 410 Ste 100
San Antonio, TX 78217-4660
Phone
(210) 656-7177
Fax
(210) 656-3687
NPI assigned
Jul 20, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 267637 NY
Surgical Oncology Physician 2086X0206X 34.014960 OH
Surgical Oncology Physician 2086X0206X T2191 TX Primary

Addresses

Primary practice location

2130 NE Loop 410 Ste 100
San Antonio, TX 78217-4660

Mailing address

PO Box 911230
Dallas, TX 75391-1230
Phone (972) 997-8000

Other practice location 1

1 Akron General Ave
Akron, OH 44307-2432
Phone (330) 344-3950

Other names 1

  • Dr. Rachel Ellen Beveridge Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220901001993 TX Practitioner - Surgical Oncology 8426371543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Oncology PAGroup PAC ID 5395658934, 1,001 clinicians

Practice addresses (Care Compare)

2130 NE Loop
410 Suite 100
San Antonio, TX 78217-4660
Phone (210) 656-7177

Hospital & facility affiliations

  • Christus Santa Rosa Hospital-San Marcos Hospital, San Marcos, TX, CCN 450272
  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388
  • Methodist Hospital Stone Oak Hospital, San Antonio, TX, CCN 670055

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as apm
Quality
67.48
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy46
Melanoma (skin cancer) excision11
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
267637NYMDSurgery Physician
34.014960OHMDSurgical Oncology Physician
T2191TXMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Oncology PA Surgery CurrentSince Oct 1, 2022 Accepting new patients
Texas Oncology PA Surgery CurrentSince Oct 1, 2022 Accepting new patients
Texas Oncology PA Surgery Current Accepting new patients

Locations

7848 Gateway Blvd E
El Paso, TX 79915
Phone (915) 599-1313

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

2130 NE Loop 410
Ste 100
San Antonio, TX 78217
Phone (210) 242-6541

Interoperability endpoints

  • Direct secure messaging: rachel.kaczynski@txo.ikm.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1487942736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "972-997-8000",
            "fax_number": "972-234-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 NE LOOP 410 STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782174660",
            "telephone_number": "210-656-7177",
            "fax_number": "210-656-3687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Akron General Ave",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443072432",
            "country_code": "US",
            "telephone_number": "330-344-3950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KACZYNSKI",
        "first_name": "RACHEL",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-20",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "267637",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "OH",
            "license": "34.014960",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "TX",
            "license": "T2191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "BEVERIDGE",
            "middle_name": "ELLEN",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.