Individual provider Active NPI

Matthew David Kasulke, M.D.

  • Surgery Physician
  • Auburn, NY
National Provider Identifier
1073838629
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
284157 Issued in NY
Practice address
Surgical Services of Auburn
77 Nelson Street, Suite 320
Auburn, NY 13021
Phone
(315) 253-1832
NPI assigned
Apr 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 284157 NY Primary

Addresses

Primary practice location

Surgical Services of Auburn
77 Nelson Street, Suite 320
Auburn, NY 13021

Mailing address

17 Lansing St
Auburn, NY 13021-1983
Phone (315) 253-1832

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160621001246 NY Practitioner - General Surgery 8527379684 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
State University of Ny Upstate Medical University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Auburn Memorial Medical Services PCGroup PAC ID 6406931385, 121 clinicians

Practice addresses (Care Compare)

143 N St
Suite 1
Auburn, NY 13021-1852
Phone (315) 253-1832

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.68 of 100Reported as group
Quality
48.88
Promoting interoperability
91
Improvement activities
40
Cost
71.94

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy72
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux32
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Auburn Community Hospital CurrentSince Jan 6, 2022 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Jun 30, 2016 Accepting new patients
Auburn Community Hospital CurrentSince Jan 6, 2022 Accepting new patients
Auburn Memorial Medical Services, PC Surgery CurrentSince Jun 30, 2016 Accepting new patients

Locations

77 Nelson St
Ste 120
Auburn, NY 13021
Phone (315) 252-7550

143 North St
Ste 1
Auburn, NY 13021
Phone (315) 253-1832

17 Lansing St
#2
Auburn, NY 13021
Phone (315) 567-0670

77 Nelson St
Ste 320
Auburn, NY 13021
Phone (315) 253-1832

17 Lansing St
Sennett, NY 13021
Phone (315) 255-7011

Interoperability endpoints

  • Direct secure messaging: drkasulke@amms.medentdirect.com

Organizations & group practices 4

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 1

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": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1073838629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LANSING ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211983",
            "telephone_number": "315-253-1832",
            "fax_number": "315-702-8393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SURGICAL SERVICES OF AUBURN",
            "address_2": "77 NELSON STREET, SUITE 320",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "13021",
            "telephone_number": "315-253-1832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASULKE",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-06",
        "last_updated": "2021-04-13",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "284157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

Verify at the official NPI Registry.