Individual provider Active NPI

Michal Kaczor, MD

  • Family Medicine Physician
  • Winston Salem, NC
National Provider Identifier
1710148614
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
87826 Issued in SC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-1707
Phone
(336) 716-9252
Fax
(336) 716-0030
NPI assigned
Jun 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 87826 SC Primary
Hospitalist Physician 208M00000X 271069 NY
Internal Medicine Physician 207R00000X 21154 NH
Hospitalist Physician 208M00000X 2021-00754 NC
Family Medicine Physician 207Q00000X 25MA09024500 NJ

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-1707

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-9252

Other practice location 1

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 525-8600

Other practice location 2

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-8600

Other practice location 3

3200 MacCorkle Ave SE
Charleston, WV 25304-1227
Phone (304) 388-5432

Other names 1

  • Michal Robert Kaczor Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address michal.kaczor@camc.cernerdirect.com
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, ME, SC, NH, WV, AL, TN, NC, OH9 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 9

Enrollment IDStateProvider typePAC IDDetails
I20150610000428 NY Practitioner - Family Practice 8224205109 Reassigns benefits to 3 organizations
I20211123002049 ME Practitioner - Family Practice 8224205109 Reassigns benefits to 1 organization
I20221208001695 SC Practitioner - Family Practice 8224205109 Reassigns benefits to 3 organizations
I20230505001016 NH Practitioner - Family Practice 8224205109 Reassigns benefits to 2 organizations
I20250109000475 WV Practitioner - Family Practice 8224205109 Reassigns benefits to 2 organizations
I20250304001828 AL Practitioner - Family Practice 8224205109 Reassigns benefits to 1 organization
I20250313002791 TN Practitioner - Family Practice 8224205109 Reassigns benefits to 2 organizations
I20250428004286 NC Practitioner - HospitalistPractitioner - Internal Medicine 8224205109 Reassigns benefits to 1 organization
I20251219002831 OH Practitioner - Family Practice 8224205109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Hospital of Troy, New YorkGroup PAC ID 6507770070, 258 clinicians
St Peters Hospital of the City of AlbanyGroup PAC ID 2668460072, 268 clinicians
24 On Physicians of SC LLCGroup PAC ID 5890127344, 136 clinicians
Charleston Area Medical Center IncGroup PAC ID 3375441637, 969 clinicians
Hospital Medicine Services of NH, LLCGroup PAC ID 8527423706, 88 clinicians
Upstate Ny Doctor of Medicine PLLCGroup PAC ID 8628518750, 28 clinicians

Practice addresses (Care Compare)

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 271-3300

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-1550

316 Calhoun St
Charleston, SC 29401-1113
Phone (843) 724-2901

3200 Maccorkle Ave SE
Charleston, WV 25304-1227
Phone (304) 388-5432

333 Borthwick Ave
Portsmouth, NH 03801-7128
Phone (603) 436-5110

427 Guy Park Ave
Amsterdam, NY 12010-1064
Phone (518) 842-1900

Hospital & facility affiliations

  • St Marys Healthcare Hospital, Amsterdam, NY, CCN 330047
  • Roper St Francis Hospital-Berkeley Inc Hospital, Summerville, SC, CCN 420110
  • Roper Hospital Hospital, Charleston, SC, CCN 420087
  • Bon Secours-St Francis Xavier Hospital Hospital, Charleston, SC, CCN 420065
  • Parkland Medical Center Hospital, Derry, NH, CCN 300017

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09024500NJMDFamily Medicine Physician
271069NYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NW Ohio Hospital Medicine Physicians LLC CurrentSince Oct 13, 2025 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Sep 2, 2024 Accepting new patients
Wake Forest University Health Sciences CurrentSince Apr 20, 2025 Accepting new patients
24 On Physicians of SC, LLC Hospitalist CurrentSince Nov 1, 2025 Accepting new patients
St. Peter'S Hospital of the City of Albany Family Medicine CurrentSince Jul 27, 2015 Accepting new patients
Samaritan Hospital of Troy, New York Family Medicine CurrentSince Jan 1, 2020 Accepting new patients
Inpatient Consultants of Alabama, Inc Internal Medicine CurrentSince Sep 14, 2024 Accepting new patients
Hospital Medicine Services of NH, LLC Hospitalist CurrentSince Feb 6, 2024 Accepting new patients
Southeastern Physician Services PC Internal Medicine CurrentSince Mar 1, 2025 Accepting new patients
Upstate Ny Doctor of Medicine PLLC Hospitalist CurrentSince Jun 1, 2025 Accepting new patients
Apogee Medical Group Maine PC Internal Medicine CurrentSince Mar 3, 2025 Accepting new patients
St. Peter'S Hospital of the City of Albany Family Medicine CurrentSince Jul 27, 2015 Accepting new patients
SC Hospital Medicine Physicians LLC Internal Medicine CurrentSince Sep 2, 2022 Accepting new patients
Hospital Medicine Services of Tennessee PC Family Medicine CurrentSince May 31, 2025 Accepting new patients
Southeastern Hospitalist Services PC Family Medicine CurrentSince Feb 1, 2023 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Sep 2, 2024 Accepting new patients
HCA Health Services of New Hampshire Inc Past Accepting new patients
Valley Physician Services, Inc. Past Accepting new patients

Locations (25 of 29)

750 Morphy Ave
Fairhope, AL 36532
Phone (251) 928-2375

3719 Dauphin St
Mobile, AL 36608
Phone (251) 342-3000

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

360 Broadway
Bangor, ME 04401
Phone (207) 262-1703

93 Campus Ave
Lewiston, ME 04240
Phone (207) 755-3715

250 Hospital Dr
Lexington, NC 27292
Phone (336) 238-4150

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

1 Parkland Dr
Derry, NH 03038
Phone (603) 421-2220

333 Bothwick Ave
Portsmouth, NH 03801
Phone (603) 433-4907

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

4 Palisades Dr
Ste 200
Albany, NY 12205
Phone (518) 591-1121

427 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 442-1404

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

950 W Wooster St
Bowling Green, OH 43402
Phone (419) 354-8900

1900 S Main St
Findlay, OH 45840
Phone (419) 423-4500

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

1000 Medical Center Dr
Hardeeville, SC 29927
Phone (843) 784-8138

25 Hospital Ctr
Hilton Head Island, SC 29926
Phone (843) 682-2345

800 W Meeting St
Lancaster, SC 29720
Phone (803) 286-1214

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

100 Callen Blvd
Summerville, SC 29486
Phone (845) 529-3165

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

106 Medical Center Blvd
Fayetteville, TN 37334
Phone (931) 438-1100

742 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 429-6100

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Interoperability endpoints

  • Direct secure messaging: michal.kaczor@camc.cernerdirect.com
  • Direct secure messaging: mkaczor3027327@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: mkaczor789035@direct.trinity-health.org

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 5

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": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1710148614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-9252",
            "fax_number": "336-716-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271571707",
            "telephone_number": "336-716-9252",
            "fax_number": "336-716-0030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Burdett Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802466",
            "country_code": "US",
            "telephone_number": "518-525-8600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 S Manning Blvd",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122081707",
            "country_code": "US",
            "telephone_number": "518-525-8600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 MacCorkle Ave SE",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253041227",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KACZOR",
        "first_name": "MICHAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "87826",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "271069",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "21154",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2021-00754",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA09024500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michal.kaczor@camc.cernerdirect.com",
            "affiliation": "N",
            "address_1": "3200 MacCorkle Ave SE",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253041227",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPH Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MICHAL",
            "last_name": "KACZOR",
            "middle_name": "ROBERT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.