Individual provider Active NPI

Christopher J Kaczmarczyk, DO

  • Emergency Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1912325689
Registry record updated Jul 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
61635 Issued in MN
Practice address
701 Park Ave
HCMC Department of Emergency Medicine - Mail Code 825
Minneapolis, MN 55415-1623
Phone
(612) 873-5645
NPI assigned
Mar 31, 2014
Last updated
Jul 24, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 61635 MN Primary

Addresses

Primary practice location

701 Park Ave
HCMC Department of Emergency Medicine - Mail Code 825
Minneapolis, MN 55415-1623

Mailing address

701 Park Avenue S
825
Minneapolis, MN 55415
Phone (612) 873-5683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20170511001685 MN Practitioner - Emergency Medicine 8224337266 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Cuyuna Regional Medical Center CurrentSince May 1, 2017 Accepting new patients
Fairview Express Care CurrentSince Jul 5, 2017 Accepting new patients
Cuyuna Regional Medical Center CurrentSince May 1, 2017 Accepting new patients
Fairview Health Services CurrentSince Jul 5, 2017 Accepting new patients
Cuyuna Regional Medical Center Current Accepting new patients

Locations

320 E Main St
Crosby, MN 56441
Phone (218) 546-7000

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500854400000",
    "number": "1912325689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PARK AVENUE S",
            "address_2": "825",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55415",
            "telephone_number": "612-873-5683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PARK AVE",
            "address_2": "HCMC DEPARTMENT OF EMERGENCY MEDICINE - MAIL CODE 825",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151623",
            "telephone_number": "612-873-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZMARCZYK",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-31",
        "last_updated": "2017-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "61635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.