DR. THEODORE KACZMAR JR. MD
NPI 1265449136
Neurological Surgery in Salinas, CA

Q: What is Theodore Kaczmar's NPI number?

The NPI number for Theodore Kaczmar is 1265449136. It was assigned to this individual provider in the NPPES registry on August 2, 2006.

Q: What is Theodore Kaczmar's specialty?

The primary specialty registered for this NPI is Neurological Surgery with taxonomy code 207T00000X.

Q: When was this NPI record last updated?

The NPPES record for Theodore Kaczmar was last updated on May 1, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 02, 2006PECOS EnrolledAccepts Medicare Assignment

220 SAN JOSE ST, SALINAS, CA 93901(831) 424-0807(831) 424-3408 Get Directions Write a Review

NPPES record last updated: May 1, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 1, 2019, Nov 13, 2018 (2 updates tracked since 2018).

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About Dr. Theodore Kaczmar Jr. Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THEODORE KACZMAR JR. MD (NPI 1265449136) is an individual neurological surgery provider in Salinas, California, licensed in California (G546380) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Washington University School Of Medicine (1979).

NPPES Registry Identity

NPI1265449136

Entity TypeIndividualMale

Primary Taxonomy207T00000X

Provider Legal NameDR. THEODORE KACZMAR JR.Credential: MD

Location Address220 SAN JOSE STSalinas, CA 93901-3901

Mailing Address1033 Los Palos DrSalinas, CA 93901-3916 · (831) 757-2058 · Fax (831) 757-0232

Phone(831) 424-0807

Fax(831) 424-3408

Sole ProprietorNo

Medical School CMSWashington University School Of MedicineGraduated 1979

Enumeration DateAugust 2, 2006

Last NPPES UpdateMay 1, 20192 updates tracked since enumeration

✔ NPI 1265449136 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNeurological SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207T00000X

License✔ Licensed in CA · G546380

Definition

A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.

220 SAN JOSE ST, Salinas, CA 93901

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Other Identifiers 2

MedicaidZZZ70373ZCA

Other94170316793901A002Tricare

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Theodore Kaczmar Jr. Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID941268940

PECOS Enrollment IDI20041222000220

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

241 services131 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

85 services85 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

53 services31 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

48 services48 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

43 services34 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 93901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$139.84 typical visit price

range $61.69 – $184.30

Typical copayment $34.96 (range $15.42 – $46.07)

Most-billed visit code 99204

Established Patient

$76.53 typical visit price

range $20.34 – $151.02

Typical copayment $19.13 (range $5.08 – $37.75)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

0%416 patients1/55-star benchmark: 85%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

93%1,612 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

79%603 patients3/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

68%665 patients2/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

6%882 patients1/55-star benchmark: 99%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

22%705 patients1/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients tobacco: 5% · 318 patients

15%318 patients

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

14%882 patients1/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

14%882 patients1/55-star benchmark: 89%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: - Adults aged >= 21 years who were previously diagnosed with or currently have an active…

50%64 patients2/55-star benchmark: 89%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 1% · 268 patients

4%268 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GUS GEORGE HALAMANDARIS MD

Neurological Surgery