Active NPI
Martha Maria Kachmaryk, MD
- Ophthalmology Physician
- Chicago, IL
National Provider Identifier
1528110392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 036092803
- Practice address
- 2004 N Pulaski Rd
Chicago, IL 60639-3767 - Phone
- (773) 772-8876
- Fax
- (773) 252-8091
- NPI assigned
- Jan 18, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 036092803 | IL | Primary |
Addresses
Primary practice location
2004 N Pulaski Rd
Chicago, IL 60639-3767
Mailing address
2004 N Pulaski Rd
Chicago, IL 60639-3767
Phone (773) 772-8876
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0004932263 | Other | IL | BCBS NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036092803 | IL | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohio Valley Eye Institute | Ophthalmology | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443744000000",
"number": "1528110392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2004 N PULASKI RD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606393767",
"telephone_number": "773-772-8876",
"fax_number": "773-252-8091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2004 N PULASKI RD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606393767",
"telephone_number": "773-772-8876",
"fax_number": "773-252-8091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KACHMARYK",
"first_name": "MARTHA",
"middle_name": "MARIA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-18",
"last_updated": "2015-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IL",
"license": "036092803",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NUMBER",
"identifier": "0004932263",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.