NPIMap

Individual provider Active NPI

John K Kula, MD

  • Anesthesiology Physician
  • Peoria, IL
National Provider Identifier
1124017124
Registry record updated Jul 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036100291 Issued in IL
Practice address
8600 N State Route 91
Ste 250
Peoria, IL 61615-9506
Phone
(309) 692-5393
Fax
(309) 692-2538
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036100291 IL Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X 036100291 IL
Family Medicine Physician 207Q00000X 036100291 IL

Addresses

Primary practice location

8600 N State Route 91
Ste 250
Peoria, IL 61615-9506

Mailing address

8600 N State Route 91
Ste 250
Peoria, IL 61615-9506
Phone (309) 692-5393

Other identifiers 1

IdentifierTypeStateIssuer
036100291MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101018000409 IL Practitioner - Anesthesiology 7719170265 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Uniformed Services Uhs Fe Hebert School of Med, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Medical Center of IllinoisGroup PAC ID 1355259714, 387 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-5654

5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-1000

600 S 13TH St
Pekin, IL 61554-4936

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

  • Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209
  • Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013
  • Carle Health Pekin Hospital Hospital, Pekin, IL, CCN 140120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Anesthesiologists, S.C. Anesthesiology CurrentSince Dec 1, 1999 Accepting new patients
North American Partners in Anesthesia (Illinois), LLC Anesthesiology CurrentSince Jan 10, 2021 Accepting new patients
Methodist Medical Center of Illinois Anesthesiology CurrentSince Jul 11, 2018 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Jul 11, 2018 Accepting new patients
Associated Anesthesiologists, SC Anesthesiology CurrentSince Dec 6, 2020 Accepting new patients
Carle Health Care Incorporated Anesthesiology CurrentSince Jan 1, 2026 Accepting new patients
Major Hospital Past Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

2200 E Washington St
Bloomington, IL 61701
Phone (309) 662-3311

6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393

530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

8600 State Route 91
Ste 250
Peoria, IL 61615
Phone (309) 692-5393

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 4

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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280448000000",
    "number": "1124017124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 N STATE ROUTE 91",
            "address_2": "STE 250",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616159506",
            "telephone_number": "309-692-5393",
            "fax_number": "309-692-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 N STATE ROUTE 91",
            "address_2": "STE 250",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616159506",
            "telephone_number": "309-692-5393",
            "fax_number": "309-692-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULA",
        "first_name": "JOHN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2010-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036100291",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036100291",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036100291",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100291",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.