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ALEXANDER WOLODYMYR KMICIKEWYCZ MD
NPI 1710097779
Internal Medicine in Palos Heights, IL

Active since August 30, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 14D0878278 · Waiver
12622 SOUTH HARLEM AVENUE, PALOS HEIGHTS, IL 60463(708) 923-9610(708) 923-9613 Get Directions Write a Review

NPPES record last updated: December 29, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Alexander Wolodymyr Kmicikewycz Md NPPES

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

ALEXANDER WOLODYMYR KMICIKEWYCZ MD (NPI 1710097779) is an individual internal medicine provider in Palos Heights, Illinois, licensed in Illinois (036064794) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through October 20, 2027, and is affiliated with Palos Community Hospital.

NPPES Registry Identity

NPI1710097779
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameALEXANDER WOLODYMYR KMICIKEWYCZCredential: MD
Location Address12622 SOUTH HARLEM AVENUEPalos Heights, IL 60463-1428
Mailing Address12622 South Harlem AvenuePalos Heights, IL 60463-1428 · (708) 923-9610 · Fax (708) 923-9613
Phone(708) 923-9610
Fax(708) 923-9613
Sole ProprietorYes
Medical School CMSR Franklin University Of Med & Sci/chicago Medical SchoolGraduated 1981
Enumeration DateAugust 30, 2006
Last NPPES UpdateDecember 29, 2021
NPPES CertifiedDecember 29, 2021
✔ NPI 1710097779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036064794
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

12622 SOUTH HARLEM AVENUE, Palos Heights, IL 60463
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Other Identifiers 1

Other31601176Blue Cross Blue Shield Il

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

Alexander Wolodymyr Kmicikewycz 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 ID2062597669
PECOS Enrollment IDI20080306000440
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 14D0878278

Alexander W Kmicikewycz · Palos Heights, IL
Active · expires Oct 20, 2027
CLIA Number14D0878278
Laboratory TypePhysician Office
Certificate Effective DateOctober 21, 2025
Certificate Expiration DateOctober 20, 2027
Laboratory DirectorAlexander W. Kmicikewycz
Laboratory Phone(708) 923-9610
Laboratory LocationAlexander W Kmicikewycz12622 S Harlem Avenue, Palos Heights, IL 60463
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 10

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, 30-39 minutes 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.
612 services267 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
166 services166 patients
Established patient office or other outpatient visit, 40-54 minutes 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
106 services81 patients
Established patient office or other outpatient visit, 20-29 minutes 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.
98 services75 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
81 services16 patients
Transitional care management services for problem of high complexity 99496
Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.
26 services24 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Palos Community Hospital

Acute Care Hospitals · Palos Heights, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140062
Location12251 South 80th AvenuePalos Heights, IL 60463 · Cook County
Emergency services Birthing friendly

Ingalls Memorial Hospital

Acute Care Hospitals · Harvey, IL
2/5 CMS rating
OwnershipPhysician
CMS Certification Number140191
Location1 Ingalls DriveHarvey, IL 60426 · Cook County
Emergency services Birthing friendly

Advocate Christ Hospital & Medical Center

Acute Care Hospitals · Oak Lawn, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140208
Location4440 W 95th StreetOak Lawn, IL 60453 · Cook County
Emergency services Birthing friendly

Silver Cross Hospital And Medical Centers

Acute Care Hospitals · New Lenox, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140213
Location1900 Silver Cross BlvdNew Lenox, IL 60451 · Will County
Emergency services Birthing friendly

Northwestern Medicine Central Dupage Hospital

Acute Care Hospitals · Winfield, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140242
Location25 North Winfield RoadWinfield, IL 60190 · Du Page County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60463 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
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
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.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
12 suppliers26 claims82 services$5.94 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers13 claims20 services$1.11 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
1 supplier11 claims11 services$45.66 avg. paid by Medicare
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) E0630
DME-Other DME · category DE000N
1 supplier11 claims11 services$41.72 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers32 claims32 services$67.53 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Alexander Kmicikewycz's NPI number?

The NPI number for Alexander Kmicikewycz is 1710097779. It was assigned to this individual provider in the NPPES registry on August 30, 2006.

Where is Alexander Kmicikewycz located?

Alexander Kmicikewycz practices at 12622 South Harlem Avenue, Palos Heights, IL 60463. The listed phone number is (708) 923-9610.

What is Alexander Kmicikewycz's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Alexander Kmicikewycz enrolled in Medicare?

Yes. Alexander Kmicikewycz 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 Alexander Kmicikewycz hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0878278) is associated with this NPI, valid through October 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Alexander Kmicikewycz affiliated with any hospitals?

According to CMS data, Alexander Kmicikewycz is affiliated with Palos Community Hospital, Ingalls Memorial Hospital, Advocate Christ Hospital & Medical Center, Silver Cross Hospital And Medical Centers and Northwestern Medicine Central Dupage Hospital.

When was this NPI record last updated?

The NPPES record for Alexander Kmicikewycz was last updated on December 29, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.