Individual provider Active NPI

Jennifer A Kulick, MD

  • Surgery Physician
  • Chelsea, MI
National Provider Identifier
1265511851
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301069984 Issued in MI
Practice address
14650 E Old US 12
Ste 303
Chelsea, MI 48118-1383
Phone
(734) 475-4177
NPI assigned
Nov 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301069984 MI Primary

Addresses

Primary practice location

14650 E Old US 12
Ste 303
Chelsea, MI 48118-1383

Mailing address

24 Frank Lloyd Wright Dr
PO Box 0446 Lobby J
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050420001343 MI Practitioner - General Surgery 4688612542 Reassigns benefits to 1 organization
I20230721000215 OH Practitioner - General Surgery 4688612542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Michigan State University College of Human Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

5308 Harroun Rd
Suite 180
Sylvania, OH 43560-2190
Phone (419) 824-6559

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy60
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Surgery CurrentSince Jul 8, 2023 Accepting new patients
Iha Health Service Corporation CurrentSince Nov 1, 2008 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Services Corporation CurrentSince Nov 1, 2008 Accepting new patients
Promedica Central Physicians CurrentSince Jul 8, 2023 Accepting new patients
Michigan Multispecialty Physicians, P.C. Surgery Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

7575 Grand River Rd
Ste 202
Brighton, MI 48114
Phone (810) 844-7566

14650 E Old US Highway 12
Ste 303
Chelsea, MI 48118
Phone (734) 475-4177

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5325 Elliott Dr
Ste 203
Ypsilanti, MI 48197
Phone (734) 712-8020

5333 McAuley Dr
Rm 3001
Ypsilanti, MI 48197
Phone (734) 712-4120

5325 Elliott Dr
Ste 104
Ypsilanti, MI 48197
Phone (734) 434-4200

5333 McAuley Dr
Rm 2115
Ypsilanti, MI 48197
Phone (734) 712-3971

5308 Harroun Rd
Ste 280
Sylvania, OH 43560
Phone (419) 824-1888

5308 Harroun Rd
Ste 180
Sylvania, OH 43560
Phone (419) 291-7555

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411948800000",
    "number": "1265511851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "address_2": "PO BOX 0446 LOBBY J",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14650 E OLD US 12",
            "address_2": "STE 303",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181383",
            "telephone_number": "734-475-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULICK",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2014-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301069984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelsea, MI

Sources for this page

Verify at the official NPI Registry.