Lawrence Timothy Kacmar, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

036-091557 Issued in IL

Practice address

3965 75TH St
Suite 103
Aurora, IL 60504-7925

Phone

(630) 375-1625

Fax

(630) 375-1925

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Family Practice

Education

Indiana Medical College, School of Medicine of Purdue University, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Complexcare Medical Group Midwest H PLLCGroup PAC ID 0143737148, 128 clinicians

Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Serenity Hospice and Home Hospice, Oregon, IL, CCN 141579
• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
• Osf Saint Katharine Medical Center Hospital, Dixon, IL, CCN 140012
• Edward Hospital Hospital, Naperville, IL, CCN 140231
• Swedish Hospital Hospital, Chicago, IL, CCN 140114
• Copley Memorial Hospital Hospital, Aurora, IL, CCN 140029
• Dixon Rehab & HCC Nursing home, Dixon, IL, CCN 145906

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Complexcare Medical Group Midwest H PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1457144933

  IL

  Medicare reassignment Care Compare group NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  IL

  Medicare reassignment Care Compare group NPD
• Lawrence T. Kacmar M.D., S.C.

  • Sports Medicine (Family Medicine) Physician
  • Aurora, IL
  • NPI 1235225269
  Medicare reassignment
• Lawrence T. Kacmar MDSC

  • Durable Medical Equipment & Medical Supplies
  • Aurora, IL
  • NPI 1255567558
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Central Dupage Hospital Association

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation
• Copley Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Aurora, IL
  • NPI 1295882561
  Care Compare affiliation
• Dixon Manor, LLC

  • Skilled Nursing Facility
  • Dixon, IL
  • NPI 1760482673

  Nursing home

  Care Compare affiliation
• Edward Hospital

  • General Acute Care Hospital
  • Naperville, IL
  • NPI 1427069632
  Care Compare affiliation
• Osf Healthcare System

  • General Acute Care Hospital
  • Dixon, IL
  • NPI 1508683590
  Care Compare affiliation
• Serenity Hospice and Home

  • Community Based Hospice Care Agency
  • Oregon, IL
  • NPI 1184661100
  Care Compare affiliation
• Swedish Covenant Health

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1831151257
  Care Compare affiliation

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393372800000",
    "number": "1699861682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3965 75TH ST",
            "address_2": "SUITE 103",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047925",
            "telephone_number": "630-375-1625",
            "fax_number": "630-375-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3965 75TH ST",
            "address_2": "SUITE 103",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047925",
            "telephone_number": "630-375-1625",
            "fax_number": "630-375-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACMAR",
        "first_name": "LAWRENCE",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IL",
            "license": "036-091557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091557",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "17167232",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "0002232125",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Jurek
• Hannah Jurkevicius, LCSW
• Justplay Pediatric Therapy and Children'S Play Space LLC
• K Qadir SC
• Lama Alghanem Kabir, DMD
• Kinjal Kadakia, M.D.
• Melissa Kain, LCSW CADC
• Celia Helen Kaiser, BCBA
• Nisha Chhablani Kakodkar, M.D.
• Siddharth Arvind Kakodkar, M.D.

• Sports Medicine (Family Medicine) Physician in Aurora, IL
• Providers in Aurora, IL by specialty
• Sports Medicine (Family Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2014; 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.