NPIMap

Individual provider Active NPI

Kyle Rulka, PA-C

  • Physician Assistant
  • Neptune, NJ
National Provider Identifier
1194555631
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00876400 Issued in NJ
Practice address
19 Davis Ave FL 4
Neptune, NJ 07753-4488
Phone
(732) 212-6598
NPI assigned
Aug 7, 2024
Last updated
Sep 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00876400 NJ Primary

Addresses

Primary practice location

19 Davis Ave FL 4
Neptune, NJ 07753-4488

Mailing address

19 Davis Ave FL 4
Neptune, NJ 07753-4488
Phone (732) 212-6598

Other practice location 1

19 Davis Ave Fl 4
Neptune, NJ 07753-4488
Phone (732) 212-6598

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20240927000398 NJ Practitioner - Physician Assistant 4587195821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1140 Route 72 W
Manahawkin, NJ 08050-2412
Phone (609) 597-6011

135 Hwy 35
Eatontown, NJ 07724-1813
Phone (732) 897-7944

19 Davis Ave
Neptune, NJ 07753-4488

1944 Route 33
Neptune, NJ 07753
Phone (732) 776-3787

1945 Route 33
Neptune, NJ 07753

30 Prospect Ave
Hackensack, NJ 07601-1915

3600 Route 66
FL 3
Neptune, NJ 07753

727 N Beers St
Holmdel, NJ 07733-1514
Phone (732) 714-2700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Sep 18, 2024 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Sep 18, 2024 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1944 State Route 33
Neptune, NJ 07753
Phone (732) 776-3787

19 Davis Ave
Fl 4
Neptune City, NJ 07753
Phone (732) 212-6598

331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0880

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

Hospital & facility affiliations 7

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": "1722988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1194555631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 DAVIS AVE FL 4",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534488",
            "telephone_number": "732-212-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 DAVIS AVE FL 4",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534488",
            "telephone_number": "732-212-6598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Davis Ave Fl 4",
            "address_purpose": "LOCATION",
            "city": "Neptune",
            "state": "NJ",
            "postal_code": "077534488",
            "country_code": "US",
            "telephone_number": "732-212-6598",
            "fax_number": "732-922-2026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RULKA",
        "first_name": "KYLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00876400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

Verify at the official NPI Registry.