Active NPI
Diane Alice Culik, MD
- Family Medicine Physician
- Grand Rapids, MI
National Provider Identifier
1053378034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 038399
- Practice address
- 2644 Florlen Ave NE
Grand Rapids, MI 49525-3968 - Phone
- (855) 669-9355
- Fax
- (888) 480-3870
- NPI assigned
- Apr 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 038399 | MI | Primary |
Addresses
Primary practice location
2644 Florlen Ave NE
Grand Rapids, MI 49525-3968
Mailing address
2644 Florlen Ave NE
Grand Rapids, MI 49525-3968
Phone (313) 443-1306
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 31, 2013 through Dec 31, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038399 | MI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672704000000",
"number": "1053378034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2644 FLORLEN AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495253968",
"telephone_number": "313-443-1306",
"fax_number": "888-480-3870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2644 FLORLEN AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495253968",
"telephone_number": "855-669-9355",
"fax_number": "888-480-3870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CULIK",
"first_name": "DIANE",
"middle_name": "ALICE",
"name_prefix": "Ms.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-26",
"last_updated": "2023-01-03",
"certification_date": "2023-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "038399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.