Individual provider Active NPI

Ronald Stephan Kulik II, D.C.

  • Chiropractor
  • Reston, VA
National Provider Identifier
1063508919
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104000966 Issued in VA
Practice address
11495 Sunset Hills Rd Ste 240
Reston, VA 20190-5257
Phone
(703) 742-7856
Fax
(703) 740-4064
NPI assigned
Oct 5, 2006
Last updated
Feb 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104000966 VA Primary

Addresses

Primary practice location

11495 Sunset Hills Rd Ste 240
Reston, VA 20190-5257

Mailing address

11664 Preference Way
Herndon, VA 20170-2486
Phone (703) 505-1677

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL dr.kulik@cccreston.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131015000337 DC Practitioner - Chiropractic 8426092503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Chiropractic Center of Reston, P.C.Group PAC ID 5799729869, 2 clinicians

Practice addresses (Care Compare)

11495 Sunset Hills Rd
Suite 240
Reston, VA 20190-5257
Phone (703) 742-7856

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104000966VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Natural Health Therapies LLC Chiropractor CurrentSince Dec 8, 2024 Accepting new patients
Commonwealth Chiropractic Center of Reston, P.C. Chiropractor CurrentSince Oct 15, 1991 Accepting new patients
Rose Chiropractic LLC Chiropractor Past Accepting new patients

Locations

11319 Sunset Hills Rd
Reston, VA 20190
Phone (703) 742-7856

11495 Sunset Hills Rd
Ste 240
Reston, VA 20190
Phone (703) 742-7556

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1063508919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11664 PREFERENCE WAY",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201702486",
            "telephone_number": "703-505-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11495 SUNSET HILLS RD STE 240",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905257",
            "telephone_number": "703-742-7856",
            "fax_number": "703-740-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULIK",
        "first_name": "RONALD",
        "middle_name": "STEPHAN",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104000966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "dr.kulik@cccreston.com",
            "affiliation": "N",
            "address_1": "11495 Sunset Hills Rd Ste 240",
            "city": "Reston",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201905257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.