Individual provider Active NPI

Olga Kuchmak, MD

  • Internal Medicine Physician
  • Palmetto, FL
National Provider Identifier
1720288509
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME117083 Issued in FL
Practice address
931 10TH St E
Palmetto, FL 34221-4131
Phone
(941) 933-8103
Fax
(941) 933-8104
NPI assigned
Jul 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101247817 VA
Internal Medicine Physician 207R00000X ME117083 FL Primary

Addresses

Primary practice location

931 10TH St E
Palmetto, FL 34221-4131

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (941) 933-8102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20131121001680 FL Practitioner - Internal Medicine 0446374128 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

931 10TH St E
Palmetto, FL 34221-4131
Phone (941) 933-8103

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101247817VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Internal Medicine CurrentSince Apr 25, 2022 Accepting new patients
Millennium Physician Group LLC CurrentSince Apr 25, 2022 Accepting new patients
Hospital Internal Medicine PA CurrentSince Oct 16, 2013 Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

6500 W Newberry Rd
Gainesville, FL 32605
Phone (352) 333-4180

931 10th St E
Palmetto, FL 34221
Phone (941) 847-7903

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: olga.kuchmak.1@4290.direct.athenahealth.com
  • Direct secure messaging: olgakuchmak@kdc.ssdirect.aprima.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1720288509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "941-933-8102",
            "fax_number": "941-933-8104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 10TH ST E",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342214131",
            "telephone_number": "941-933-8103",
            "fax_number": "941-933-8104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCHMAK",
        "first_name": "OLGA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101247817",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME117083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto, FL

Sources for this page

Verify at the official NPI Registry.