Kyle C Sierocuk, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

125894 Issued in AR

Practice address

4700 S Thompson St Ste C103
Springdale, AR 72764-2558

Phone

(479) 571-6363

NPI assigned

Jul 9, 2020

Last updated

Aug 14, 2024By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AR

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kyle.sierocuk@mana.eclinicaldirectplus.com

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.

• Medical Associates of Northwest Arkansas, PA

  • Internal Medicine Physician
  • Fayetteville, AR
  • NPI 1801847827
  Medicare reassignment NPD
• Medical Associates of Northwest Arkansas PA

  • Diagnostic Radiology Physician
  • Harrison, AR
  • NPI 1598243560
  NPD
• Medical Associates of Northwest Arkansas PA

  • Family Medicine Physician
  • Lowell, AR
  • NPI 1912883273
  NPD
• Medical Associates of Northwest Arkansas PA

  • Podiatrist
  • Fayetteville, AR
  • NPI 1164140729
  NPD (past)
• Medical Associates of Northwest Arkansas PA

  • Family Medicine Physician
  • Fayetteville, AR
  • NPI 1710218995
  NPD (past)
• Shawnte Farmer Psychiatric Services PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Rogers, AR
  • NPI 1982176335
  NPD (past)

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1235757816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1523",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727021523",
            "telephone_number": "479-571-6038",
            "fax_number": "479-582-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 S THOMPSON ST STE C103",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727642558",
            "telephone_number": "479-571-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEROCUK",
        "first_name": "KYLE",
        "middle_name": "C",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-09",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "125894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kyle.sierocuk@mana.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Provider's direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "4700 S Thompson St Ste C103",
            "city": "Springdale",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727642558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Marie Shuler, LCSW
• Sabina M Siddiqui, MD
• Kelsey Siebenmorgen
• Billie Sue Siebert, RN
• Konrad Siemek, PT
• Jerry Roberts Silk, MHPP
• Carlos Francisco Silva-Nunez, MHPP
• Boris Ivan Silva, MHPP
• Chrystal Shanae Silva, MHPP
• Justin Silveira

• Psychiatric/Mental Health Nurse Practitioner in Springdale, AR
• Providers in Springdale, AR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.