Organization Active NPI

Rastislav Kucinsky MD PC

  • Interventional Cardiology Physician
  • Klamath Falls, OR
National Provider Identifier
1205119799
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD28454 Issued in OR
Legal business name
RASTISLAV KUCINSKY MD PC
Practice address
2614 Clover St
Klamath Falls, OR 97601-1132
Phone
(541) 884-6233
NPI assigned
Sep 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Authorized official

Name
Dr. Rastislav Kucinsky, MD
Title
Owner
Phone
(541) 884-6233

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X MD28454 OR
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X MD28454 OR Primary

Addresses

Primary practice location

2614 Clover St
Klamath Falls, OR 97601-1132

Mailing address

PO Box 5109
Klamath Falls, OR 97601-0119
Phone (541) 882-1540

Other identifiers 2

IdentifierTypeStateIssuer
026194MedicaidOR
P00641241OtherORRAILROAD MEDICARE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321920000000",
    "number": "1205119799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5109",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976010119",
            "telephone_number": "541-882-1540",
            "fax_number": "541-882-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2614 CLOVER ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011132",
            "telephone_number": "541-884-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RASTISLAV KUCINSKY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-11-22",
        "status": "A",
        "authorized_official_last_name": "KUCINSKY",
        "authorized_official_first_name": "RASTISLAV",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-884-6233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD28454",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OR",
            "license": "MD28454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026194",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00641241",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; 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.