Individual provider Active NPI

Elizabeth Kulik, DPT

  • Physical Therapist
  • Syracuse, NY
National Provider Identifier
1184032468
Registry record updated Sep 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4651 Nixon Park Drive
Syracuse, NY 13215-9759
Phone
(315) 492-0592
Fax
(315) 492-1203
NPI assigned
Jul 30, 2014
Last updated
Sep 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

4651 Nixon Park Drive
Syracuse, NY 13215-9759

Mailing address

2010 Whisper Ridge Dr
Chittenango, NY 13037-9733
Phone (315) 663-5714

Other practice location 1

604 Old Liverpool Rd Ste 2
Liverpool, NY 13088-6033
Phone (315) 492-0592

Other names 1

  • Elizabeth Dungan Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141208000100 NY Practitioner - Physical Therapist in Private Practice 3173845807 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Lou Corcoran PT, P.C. CurrentSince Jul 1, 2020 Accepting new patients
Onondaga Physical Therapy, LLC Physical Therapist Past Accepting new patients

Locations

6711 Towpath Rd
East Syracuse, NY 13057
Phone (315) 637-4747

6711 Towpath Rd
Ste 100
East Syracuse, NY 13057
Phone (315) 637-4747

Organizations & group practices 2

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": "1406678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1184032468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 WHISPER RIDGE DR",
            "city": "CHITTENANGO",
            "state": "NY",
            "postal_code": "130379733",
            "telephone_number": "315-663-5714",
            "fax_number": "315-679-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4651 NIXON PARK DRIVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132159759",
            "telephone_number": "315-492-0592",
            "fax_number": "315-492-1203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "604 Old Liverpool Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Liverpool",
            "state": "NY",
            "postal_code": "130886033",
            "country_code": "US",
            "telephone_number": "315-492-0592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KULIK",
        "first_name": "ELIZABETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-30",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "DUNGAN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.