Active NPI
Richard Kasulke, MD
- Urology Physician
- Geneva, NY
National Provider Identifier
1093898652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 139140
- Practice address
- 200 North St
Suite 101
Geneva, NY 14456-1561 - Phone
- (315) 787-5100
- Fax
- (315) 787-5108
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 139140 | NY | Primary |
Addresses
Primary practice location
200 North St
Suite 101
Geneva, NY 14456-1561
Mailing address
200 North St
Suite 101
Geneva, NY 14456-1561
Phone (315) 787-5100
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P010139140 | Other | NY | BLUE SHIELD |
| 1221934FZ | Other | NY | PREFERRED CARE |
| 61640335 | Other | NY | GHI |
| 66519 | Medicaid | NY |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western New York Medical Practice P.C. | Current | Accepting new patients |
Locations
200 North St
Ste 101
Geneva, NY 14456
Phone (315) 787-5100
1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Rochester, NY
- NPI 1063790608
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277683200000",
"number": "1093898652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 NORTH ST",
"address_2": "SUITE 101",
"city": "GENEVA",
"state": "NY",
"postal_code": "144561561",
"telephone_number": "315-787-5100",
"fax_number": "315-787-5108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 NORTH ST",
"address_2": "SUITE 101",
"city": "GENEVA",
"state": "NY",
"postal_code": "144561561",
"telephone_number": "315-787-5100",
"fax_number": "315-787-5108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASULKE",
"first_name": "RICHARD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2010-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NY",
"license": "139140",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "P010139140",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "1221934FZ",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "61640335",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "66519",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Geneva, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.