Mark B. Kukler, D.O.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

036800 Issued in GA

Practice address

763 Old Norcross Rd
Lawrenceville, GA 30046-4317

Phone

(678) 985-2000

Fax

(678) 985-1999

NPI assigned

May 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Gastroenterology

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
• Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252
• Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• MBK Gastro LLC

  • Gastroenterology Physician
  • Lawrenceville, GA
  • NPI 1912598699
  Medicare reassignment NPD Authorized official
• Southern Endoscopy Suite, LLC

  • Endoscopy Clinic/Center
  • Lawrenceville, GA
  • NPI 1215986609
  NPD Authorized official
• Southern Gastroenterology Associates, LLC

  • Gastroenterology Physician
  • Lawrenceville, GA
  • NPI 1205886504
  NPD Authorized official

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

• Eastside Medical Center, LLC

  • General Acute Care Hospital
  • Snellville, GA
  • NPI 1467406132
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Duluth, GA
  • NPI 1790715381
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1093765265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464317",
            "telephone_number": "678-985-2000",
            "fax_number": "678-985-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464317",
            "telephone_number": "678-985-2000",
            "fax_number": "678-985-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUKLER",
        "first_name": "MARK",
        "middle_name": "B.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "036800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00540185B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "309492",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Sue Krider
• Krisnir Corporation
• Homare Max Kubagawa, M.D.
• David William Kuglin, L.P.C.
• Amber Y Kuk, M.D.
• Arvind A. Kulkarni, M.D.
• Rashmi Arvind Kulkarni, MD
• Raveena Suhani Kumar
• Mailupillai Kumareswaran, MD
• Margaret Ann Kuneyl, OT

• Gastroenterology Physician in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Gastroenterology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; 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.

Verify at the official NPI Registry.