NPIMap

Individual provider Active NPI

Edward Kulp, PAC

  • Physician Assistant
  • Alamosa, CO
National Provider Identifier
1013907013
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1090 Issued in CO
Practice address
2115 Stuart Ave
Alamosa, CO 81101-2269
Phone
(719) 589-8082
Fax
(719) 587-6354
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1090 CO Primary

Addresses

Primary practice location

2115 Stuart Ave
Alamosa, CO 81101-2269

Mailing address

106 Blanca Ave
Alamosa, CO 81101-2340
Phone (719) 589-8082

Other identifiers 3

IdentifierTypeStateIssuer
65457820MedicaidCO
970027493OtherTRAVELERS MEDICARE
840706945074OtherCOROCKY MOUNTAIN HEALTH PLA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address pcs.ekulp@direct.slvrmc.org Direct
Direct Messaging Address pcs.ekulp@direct.slvrmc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101117000433 CO Practitioner - Physician Assistant 8820283757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lutheran Hospital Association of the San Luis Valley 146 clinicians

Practice addresses (Care Compare)

106 Blanca Ave
Alamosa, CO 81101-2340
Phone (719) 589-2511

310 County Rd
Suite 14
Del Norte, CO 81132-8758
Phone (719) 657-2510

Hospital & facility affiliations

  • Optimizing Home Health in the San Luis Valley Home health agency, Antonito, CO, CCN 067613
  • San Luis Valley Regional Medical Center Hospital, Alamosa, CO, CCN 060008
  • San Luis Valley Health Conejos County Hospital Hospital, La Jara, CO, CCN 061308

Merit-based Incentive Payment System (MIPS)

Final score
85.41 of 100Reported as group
Quality
70.25
Promoting interoperability
100
Improvement activities
40
Cost
67.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1090COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Hospital Association of the San Luis Valley CurrentSince Jan 17, 2011 Accepting new patients
Valley-Wide Health Systems, Inc. Past Accepting new patients

Locations

106 Blanca Ave
Alamosa, CO 81101
Phone (719) 589-2511

2115 Stuart Ave
Alamosa, CO 81101
Phone (719) 589-3000

310 County Road 14
Del Norte, CO 81132
Phone (719) 657-2510

Interoperability endpoints

  • Direct secure messaging: pcs.ekulp@direct.slvrmc.org

Organizations & group practices 8

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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1013907013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 BLANCA AVE",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012340",
            "telephone_number": "719-589-8082",
            "fax_number": "719-587-6354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 STUART AVE",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012269",
            "telephone_number": "719-589-8082",
            "fax_number": "719-587-6354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULP",
        "first_name": "EDWARD",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2021-05-06",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65457820",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "970027493",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROCKY MOUNTAIN HEALTH PLA",
            "identifier": "840706945074",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcs.ekulp@direct.slvrmc.org",
            "affiliation": "N",
            "endpointDescription": "San Luis Valley Health PCP Ed Kulp DIRECT Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2115 Stuart Ave",
            "city": "Alamosa",
            "state": "CO",
            "country_code": "US",
            "postal_code": "811012269",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcs.ekulp@direct.slvrmc.org",
            "affiliation": "N",
            "endpointDescription": "San Luis Valley Health PCP Edward Kulp",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2115 Stuart Ave",
            "city": "Alamosa",
            "state": "CO",
            "country_code": "US",
            "postal_code": "811012269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Alamosa, CO

Sources for this page

Verify at the official NPI Registry.