NPIMap

Individual provider Active NPI

William J Kucera, PA-C

  • Physician Assistant
  • Bismarck, ND
National Provider Identifier
1154727873
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
735 Issued in ND
Practice address
310 N 9TH St
Bismarck, ND 58501-4515
Phone
(701) 946-7500
NPI assigned
Nov 6, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1565 ND
Physician Assistant 363A00000X 735 ND Primary

Addresses

Primary practice location

310 N 9TH St
Bismarck, ND 58501-4515

Mailing address

324 Marietta Dr
Bismarck, ND 58504-7328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20180820001366 ND Practitioner - Physician Assistant 2365791613 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bone and Joint Center PCGroup PAC ID 3173416880, 40 clinicians
Omaha Therapy IncGroup PAC ID 1557270915, 68 clinicians

Practice addresses (Care Compare)

2500 Fairway St
Dickinson, ND 58601-2639
Phone (701) 946-7500

310 N 9TH St
Bismarck, ND 58501-4515
Phone (701) 946-7500

683 State Ave
Dickinson, ND 58601-4660
Phone (701) 483-9400

Hospital & facility affiliations

  • CHI St Alexius Health Hospital, Bismarck, ND, CCN 350002
  • Trinity Hospitals Hospital, Minot, ND, CCN 350006
  • CHI St Alexius Health Dickinson Hospital, Dickinson, ND, CCN 351336
  • Garrison Memorial Hospital Hospital, Garrison, ND, CCN 351303
  • Sanford Medical Center Bismarck Hospital, Bismarck, ND, CCN 350015

Merit-based Incentive Payment System (MIPS)

Final score
79.67 of 100Reported as group
Quality
80.89
Promoting interoperability
71
Improvement activities
40
Cost
75.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1565NDMDPhysical Therapist
735NDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Alexius Medical Center CurrentSince Aug 7, 2018 Accepting new patients
St. Alexius Medical Center CurrentSince Aug 7, 2018 Accepting new patients

Locations

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

Interoperability endpoints

  • Direct secure messaging: williamkucera@tbjpc.allscriptsdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 10

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": "1415232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1154727873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 MARIETTA DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585047328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014515",
            "telephone_number": "701-946-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCERA",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-06",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "1565",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.