Individual provider Active NPI

Roy M Kulick, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Cincinnati, OH
National Provider Identifier
1104199884
Registry record updated Feb 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
35061676 Issued in OH
Practice address
529 Cochise CT
Cincinnati, OH 45215-2519
Phone
(513) 460-7832
NPI assigned
Feb 11, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 35061676 OH Primary

Addresses

Primary practice location

529 Cochise CT
Cincinnati, OH 45215-2519

Mailing address

529 Cochise CT
Cincinnati, OH 45215-2519
Phone (513) 460-7832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35061676OHMDPediatric Emergency Medicine (Pediatrics) Physician

NPI Registry JSON

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

{
    "created_epoch": "1328918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328918400000",
    "number": "1104199884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 COCHISE CT",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452152519",
            "telephone_number": "513-460-7832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 COCHISE CT",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452152519",
            "telephone_number": "513-460-7832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULICK",
        "first_name": "ROY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-11",
        "last_updated": "2012-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "OH",
            "license": "35061676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.