Active NPI
Kaylin A Kultgen, PA-C
- Medical Physician Assistant
- Kokomo, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 10003933A
- Practice address
- 3500 S Lafountain St
Kokomo, IN 46902-3803 - Phone
- (765) 453-0702
- NPI assigned
- Feb 17, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10003933A | IN | |
| Medical Physician Assistant | 363AM0700X | 10003933A | IN | Primary |
Addresses
Primary practice location
3500 S Lafountain St
Kokomo, IN 46902-3803
Mailing address
6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890
Other practice location 1
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (317) 962-2000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | KKULTGEN@DIRECT.IUHEALTH.ORG | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258
Hospital & facility affiliations
- Indiana University Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Physicians of Indiana Inc | Current | Accepting new patients | |
| Indiana University Health Care Associates, Inc. | Current | Accepting new patients | |
| University Medical Diagnostic Associates, Inc. | Past | Accepting new patients |
Locations
5208 Reliable Pkwy
Chicago, IL 60686
5819 Reliable Pkwy
Chicago, IL 60686
7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444
6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
3500 S Lafountain St
Kokomo, IN 46902
Phone (765) 453-0702
Interoperability endpoints
- kkultgen551236@ecommunitydirect.com
- kkultgen@direct.iuhealth.org
Organizations & group practices 5
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.
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
-
- Family Medicine Physician
- Indianapolis, IN
- NPI 1619105244
-
- General Practice Physician
- Indianapolis, IN
- NPI 1902032832
-
- Registered Dietitian
- Indianapolis, IN
- NPI 1679949002
-
- Internal Medicine Physician
- Indianapolis, IN
- NPI 1861441537
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Indianapolis, IN
- NPI 1144266024
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744934400000",
"number": "1093413296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6626 E 75TH ST STE 500",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462502890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 S LAFOUNTAIN ST",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469023803",
"telephone_number": "765-453-0702"
}
],
"practiceLocations": [
{
"address_1": "1701 N Senate Blvd",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462021239",
"country_code": "US",
"telephone_number": "317-962-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KULTGEN",
"first_name": "KAYLIN",
"middle_name": "A",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-17",
"last_updated": "2025-04-18",
"certification_date": "2025-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10003933A",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "IN",
"license": "10003933A",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "KKULTGEN@DIRECT.IUHEALTH.ORG",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1701 N Senate Blvd",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462021239",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; 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.
- 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.