Individual provider Active NPI

Karl Kuzis, MD PHD

  • Family Medicine Physician
  • Richland, WA
National Provider Identifier
1154402253
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00040899 Issued in WA
Practice address
940 Northgate Dr
Richland, WA 99352-3505
Phone
(509) 942-2516
Fax
(509) 942-2527
NPI assigned
Oct 17, 2006
Last updated
May 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0054608 CO
Family Medicine Physician 207Q00000X MD00040899 WA Primary
Obstetrics Physician 207VX0000X MD00040899 WA

Addresses

Primary practice location

940 Northgate Dr
Richland, WA 99352-3505

Mailing address

550 Gage Blvd Ste 101
Richland, WA 99352-9532
Phone (509) 942-3627

Other practice location 1

175 S Union Blvd Ste 310
Colorado Springs, CO 80910-3126
Phone (719) 365-6363

Other identifiers 1

IdentifierTypeStateIssuer
8297426MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkuzis1109550@wm.providencedirect.org Direct

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)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MD00040899WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Wellness Center PC Family Medicine Past Accepting new patients
Legacy Salmon Creek Hospital Past Accepting new patients
Camas Family Doctor Family Medicine PastSince Jan 1, 1990 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kkuzis1109550@wm.providencedirect.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1154402253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GAGE BLVD STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529532",
            "telephone_number": "509-942-3627",
            "fax_number": "509-627-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 NORTHGATE DR",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523505",
            "telephone_number": "509-942-2516",
            "fax_number": "509-942-2527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 S Union Blvd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809103126",
            "country_code": "US",
            "telephone_number": "719-365-6363",
            "fax_number": "719-365-5801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUZIS",
        "first_name": "KARL",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0054608",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00040899",
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "WA",
            "license": "MD00040899",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8297426",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkuzis1109550@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "940 Northgate Dr",
            "city": "Richland",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993523505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.