Kyle Sulak, DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

R4906 Issued in TX

Practice address

405 Londonderry Dr Ste 105
Waco, TX 76712

Phone

(254) 776-0266

NPI assigned

Apr 4, 2014

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

Medicare fee-for-service enrollment

Enrolled in TX

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

Anesthesiology

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mid Tex Anesthesia Associates, P.a.Group PAC ID 5395815369, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Providence Hospital, Waco, TX, CCN 450042

Merit-based Incentive Payment System (MIPS)

Final score

36.76 of 100Reported as group

Quality

43.25

Improvement activities

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Mid Tex Anesthesia Associates, PA

  • Anesthesiology Physician
  • Waco, TX
  • NPI 1174612857
  Medicare reassignment Care Compare group
• Hendrick Anesthesia Network

  • Specialist
  • Abilene, TX
  • NPI 1851394993
  Medicare reassignment NPD

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

• Ascension Providence

  • General Acute Care Hospital
  • Waco, TX
  • NPI 1093708679
  Care Compare affiliation

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1104244201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 LONDONDERRY DR STE 105",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127920",
            "telephone_number": "254-776-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 LONDONDERRY DR STE 105",
            "city": "WACO",
            "state": "TX",
            "postal_code": "76712",
            "telephone_number": "254-776-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULAK",
        "first_name": "KYLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-04",
        "last_updated": "2023-07-11",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "R4906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Stumbaugh
• Keeli L Stumbo, M.D.
• Angelica Suarez, BCBA
• Arthur Wayne Sudan, MD
• George Suhm
• Kelsey Elizabeth Sullivan, SLP - ASSISTANT
• Summit Wellness - Central Texas LLC
• Sunny Day Center One LP
• Surgical Associates, P.a.
• Carleigh Sutherland, OTR

• Anesthesiology Physician in Waco, TX
• Providers in Waco, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.