BORIS KUSNETZOW M.D.
NPI 1285702357
Family Medicine in Chicago, IL

Q: What is Boris Kusnetzow's NPI number?

The NPI number for Boris Kusnetzow is 1285702357. It was assigned to this individual provider in the NPPES registry on November 30, 2006.

Q: What is Boris Kusnetzow's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Boris Kusnetzow was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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 November 30, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 14D0878451 · Waiver

6642 S ASHLAND AVE, CHICAGO, IL 60636(773) 776-3500(773) 776-8534 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Boris Kusnetzow M.d. NPPES

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

BORIS KUSNETZOW M.D. (NPI 1285702357) is an individual family medicine provider in Chicago, Illinois, licensed in Illinois (036071405) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through October 25, 2027, and is a graduate of Other (1976).

NPPES Registry Identity

NPI1285702357

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameBORIS KUSNETZOWCredential: M.D.

Location Address6642 S ASHLAND AVEChicago, IL 60636-3022

Mailing Address6642 S Ashland AveChicago, IL 60636-3022 · (773) 776-3500 · Fax (773) 776-8534

Phone(773) 776-3500

Fax(773) 776-8534

Sole ProprietorYes

Medical School CMSOtherGraduated 1976

Enumeration DateNovember 30, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1285702357 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IL · 036071405

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

6642 S ASHLAND AVE, Chicago, IL 60636

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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

Boris Kusnetzow M.d. 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 ID4284895285

PECOS Enrollment IDI20120419000135

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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0878451

Boris Kusnetzow MD · Chicago, IL

Active · expires Oct 25, 2027

CLIA Number14D0878451

Laboratory TypePhysician Office

Certificate Effective DateOctober 26, 2025

Certificate Expiration DateOctober 25, 2027

Laboratory DirectorBoris Kusnetzow, MD

Laboratory Phone(773) 776-3500

Laboratory LocationBoris Kusnetzow MD6642 S Ashland, Chicago, IL 60636

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims

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.

187 services30 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60636 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

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

Most-billed visit code 99214

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

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Boris Kusnetzow's NPI number?

The NPI number for Boris Kusnetzow is 1285702357. It was assigned to this individual provider in the NPPES registry on November 30, 2006.

Where is Boris Kusnetzow located?

Boris Kusnetzow practices at 6642 S Ashland Ave, Chicago, IL 60636. The listed phone number is (773) 776-3500.

What is Boris Kusnetzow's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Boris Kusnetzow enrolled in Medicare?

Yes. Boris Kusnetzow is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Does Boris Kusnetzow hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0878451) is associated with this NPI, valid through October 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Boris Kusnetzow was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.