Individual provider Active NPI

Laura Kujacznski, PA

  • Physician Assistant
  • Kalamazoo, MI
National Provider Identifier
1104187657
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
125 S Kalamazoo Mall
Suite 204
Kalamazoo, MI 49007-4832
Phone
(269) 324-3390
Fax
(269) 343-5640
NPI assigned
May 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MI Primary

Addresses

Primary practice location

125 S Kalamazoo Mall
Suite 204
Kalamazoo, MI 49007-4832

Mailing address

125 S Kalamazoo Mall
Suite 204
Kalamazoo, MI 49007-4832
Phone (269) 324-3390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121128000280 MI Practitioner - Physician Assistant 3678725579 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronson Methodist HospitalGroup PAC ID 0244148633, shared by 3 NPIs, 721 clinicians

Practice addresses (Care Compare)

2825 Airview Blvd
Portage, MI 49002-1802

601 John St
Kalamazoo, MI 49007-5377

940 John St
Kalamazoo, MI 49001-2857
Phone (269) 552-4266

Hospital & facility affiliations

  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017

Merit-based Incentive Payment System (MIPS)

Final score
86.43 of 100Reported as group
Quality
75.38
Promoting interoperability
100
Improvement activities
40
Cost
79.38

Merit-based Incentive Payment System (MIPS)

Final score
93.26 of 100Reported as group
Quality
79.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Methodist Hospital Physician Assistant CurrentSince Dec 1, 2015 Accepting new patients
Bronson Methodist Hospital Physician Assistant CurrentSince Jul 1, 2022 Accepting new patients

Locations

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

125 S Kalamazoo Mall
Ste 204
Kalamazoo, MI 49007
Phone (269) 343-3900

940 John St
Kalamazoo, MI 49001
Phone (269) 343-7296

6220 W Main St
Kalamazoo, MI 49009
Phone (269) 276-4744

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

601 John St
#39
Kalamazoo, MI 49007

408 Hazen St
Paw Paw, MI 49079
Phone (269) 341-8481

5121 S Westnedge Ave
Portage, MI 49002
Phone (269) 337-2110

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 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": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405641600000",
    "number": "1104187657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S KALAMAZOO MALL",
            "address_2": "SUITE 204",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074832",
            "telephone_number": "269-324-3390",
            "fax_number": "269-343-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S KALAMAZOO MALL",
            "address_2": "SUITE 204",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074832",
            "telephone_number": "269-324-3390",
            "fax_number": "269-343-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUJACZNSKI",
        "first_name": "LAURA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-31",
        "last_updated": "2014-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.