Tomislav Kucuk, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP026711 Issued in PA

Practice address

60 Glenmaura National Boulevard
Moosic, PA 18507

Phone

(570) 808-7300

NPI assigned

Jun 14, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Belleville, PA
  • NPI 1114453420
  NPD

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1215611751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 WOODCREST AVE",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187071129",
            "telephone_number": "570-239-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 GLENMAURA NATIONAL BOULEVARD",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "18507",
            "telephone_number": "570-808-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCUK",
        "first_name": "TOMISLAV",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP026711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Krabak, PHARMD, L.AC
• Michael Kreidler, MFT
• Barbara A Kreseski, LSW
• Daryl Krouse, PA-C
• Anne L. Krupa, LCSW
• John Girard Kuna, PSY.D.
• Jeannette Lasher, PA-C
• Alexander Lebiak III, DPT
• Andrew Lenway
• Devante Littlejohn

• Psychiatric/Mental Health Nurse Practitioner in Moosic, PA
• Providers in Moosic, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.