Individual provider Active NPI

Martha Maria Kachmaryk, MD

  • Ophthalmology Physician
  • Chicago, IL
National Provider Identifier
1528110392
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036092803 Issued in IL
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

Updated by the provider on Oct 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0004932263OtherILBCBS 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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036092803ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

Verify at the official NPI Registry.