Individual provider Active NPI

Stephan Kulzer

  • Hand Occupational Therapist
  • Sioux Falls, SD
National Provider Identifier
1124279195
Registry record updated Oct 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
0187 Issued in SD
Practice address
800 E 21St St
Sioux Falls, SD 57105-1016
Phone
(605) 322-5000
NPI assigned
Oct 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 0187 SD Primary

Addresses

Primary practice location

800 E 21St St
Sioux Falls, SD 57105-1016

Mailing address

800 E 21St St
Sioux Falls, SD 57105-1016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141023002727 SD Practitioner - Occupational Therapist in Private Practice 5991926594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

300 W 5TH St
Miller, SD 57362-1238
Phone (605) 853-0158

6100 S Louise Ave
Sioux Falls, SD 57108-6029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0187SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Apr 1, 2014 Accepting new patients
Avera McKennan CurrentSince Apr 1, 2014 Accepting new patients
Avera McKennan Current Accepting new patients

Locations

300 W 5th St
Miller, SD 57362
Phone (605) 853-0158

800 E 21st St
Sioux Falls, SD 57105
Phone (605) 322-2754

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.

NPI Registry JSON

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1124279195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E 21ST ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 21ST ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051016",
            "telephone_number": "605-322-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULZER",
        "first_name": "STEPHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-08",
        "last_updated": "2008-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "SD",
            "license": "0187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.