Dyman Christian Kwarciak, MD

Primary specialty

Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X

License

ME162378 Issued in FL

Practice address

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Phone

(904) 953-2000

NPI assigned

Nov 28, 2017

Last updated

Jul 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dyman Christian Shepherd Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, AZ2 enrollments

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 2

Specialty

Hospice/Palliative Care

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Arizona Healthcare CorporationGroup PAC ID 3577473362, 391 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northern Arizona Hospice Hospice, Cottonwood, AZ, CCN 031502
• Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007

Merit-based Incentive Payment System (MIPS)

Final score

82.13 of 100Reported as group

Quality

66.85

Promoting interoperability

99

Improvement activities

40

Cost

74.4

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dkwarciak1966810@ehrdirect.mayoclinicmsg.org

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• LHCG Lxxvii, LLC

  dba Northern Arizona Hospice

  • Community Based Hospice Care Agency
  • Cottonwood, AZ
  • NPI 1356702104

  W-2 Managing Employee

  CMS ownership

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.

• Northern Arizona Healthcare Corporation

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1669914552
  Medicare reassignment Care Compare group NPD
• Natarajan Medical Group of Illinois, PC

  dba AccentCare Medical Group of Illinois

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Rosemont, IL
  • NPI 1639430861
  Medicare reassignment NPD
• Northern Arizona Healthcare Corporation

  dba Northern Arizona Healthcare Children's Health Center

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1235732702
  NPD

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

• LHCG Lxxvii, LLC

  dba Northern Arizona Hospice

  • Community Based Hospice Care Agency
  • Cottonwood, AZ
  • NPI 1356702104
  Care Compare affiliation
• Verde Valley Medical Center

  • General Acute Care Hospital
  • Cottonwood, AZ
  • NPI 1346291648
  Care Compare affiliation
• Verde Valley Medical Center

  dba Northern Arizona Healthcare - Sedona

  • General Acute Care Hospital
  • Sedona, AZ
  • NPI 1538608716
  Care Compare affiliation

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1700390861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "606 Potter Rd",
            "address_purpose": "LOCATION",
            "city": "Des Plaines",
            "state": "IL",
            "postal_code": "600165337",
            "country_code": "US",
            "telephone_number": "346-376-1702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWARCIAK",
        "first_name": "DYMAN",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-28",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036154382",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "FL",
            "license": "ME162378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dkwarciak1966810@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DYMAN",
            "last_name": "SHEPHERD",
            "middle_name": "CHRISTIAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sejal S Kuthiala, MD
• Grace N Kuweruza, M.D., PHARM.D.
• Sean Joseph Kuyper, MD
• Hye Yun Kwag, PA
• Alexandria Jean Kwan, MT-BC
• Sabrina Kwok, NP
• Minkyung Kwon, MD
• Pearl Chu Kwong, MD PHD
• Wai P Kyaw, MBBS, MD
• Carl Walter Kyle, LMHC

• Hospice and Palliative Medicine (Family Medicine) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Hospice and Palliative Medicine (Family Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.