NPIMap

Individual provider Active NPI

Kim Kurak, DO

  • Family Medicine Physician
  • Brandon, VT
National Provider Identifier
1023041431
Registry record updated Jul 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
032-000525 Issued in VT
Practice address
420 Grove St
Brandon, VT 05733-9062
Phone
(802) 247-6305
Fax
(802) 247-6040
NPI assigned
Jul 9, 2006
Last updated
Jul 18, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 032-000525 VT Primary

Addresses

Primary practice location

420 Grove St
Brandon, VT 05733-9062

Mailing address

71 Allen St
Ste 403
Rutland, VT 05701-4570
Phone (802) 772-4414

Other identifiers 2

IdentifierTypeStateIssuer
NX4659OtherVTPTAN
1011619MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20050926000233 VT Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 1951335264 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Nova Southeastern Univ College of Dental Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Centers of the Rutland Region IncGroup PAC ID 2961467386, shared by 9 NPIs, 103 clinicians

Practice addresses (Care Compare)

1 General Wing Rd
Rutland, VT 05701-4681
Phone (802) 773-9131

215 Stratton Rd
Rutland, VT 05701-4621
Phone (802) 773-3386

275 Route 30 N
Bomoseen, VT 05732-9647
Phone (802) 468-5641

278 VT Route 149
West Pawlet, VT 05775-9798
Phone (802) 645-0580

420 Grove St
Brandon, VT 05733-9062
Phone (802) 247-6305

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032-000525VTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Rutland Region, Inc. Family Medicine CurrentSince Sep 4, 2012 Accepting new patients
Community Health Centers of the Rutland Region, Inc. Family Medicine CurrentSince Sep 4, 2012 Accepting new patients
Community Health Centers of the Rutland Region Inc Family Medicine Current Accepting new patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Dec 26, 2011 Accepting new patients
Community Health Centers of the Rutland Region, Inc Family Medicine CurrentSince Jul 1, 2011 Accepting new patients
Southwestern Vermont Medical Center Inc. Past Accepting new patients
Southwestern Vermont Medical Center, Inc Past Accepting new patients

Locations

275 VT 30 N
Bomoseen, VT 05732
Phone (802) 468-5641

1 General Wing Rd
Rutland, VT 05701
Phone (802) 773-9131

215 Stratton Rd
Rutland, VT 05701
Phone (802) 773-3386

71 Allen St
Ste 402
Rutland, VT 05701
Phone (800) 468-9118

71 Allen St
Ste 403
Rutland, VT 05701
Phone (802) 772-4414

2987 Vt Route 22A
Shoreham, VT 05770
Phone (802) 897-7000

278 Vt Route 149
West Pawlet, VT 05775
Phone (800) 468-9118

Interoperability endpoints

  • Direct secure messaging: kkurak@chcrr.medentdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 28

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1023041431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 ALLEN ST",
            "address_2": "STE 403",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014570",
            "telephone_number": "802-772-4414",
            "fax_number": "802-772-7973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 GROVE ST",
            "city": "BRANDON",
            "state": "VT",
            "postal_code": "057339062",
            "telephone_number": "802-247-6305",
            "fax_number": "802-247-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURAK",
        "first_name": "KIM",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "032-000525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "NX4659",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011619",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, VT

Sources for this page

Verify at the official NPI Registry.