Individual provider Active NPI

Jane Marie Kukula, AU D

  • Audiologist
  • Mentor, OH
National Provider Identifier
1295828325
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A0335 Issued in OH
Practice address
8897 Mentor Ave
Mentor, OH 44060-6211
Phone
(440) 205-8848
Fax
(440) 205-9818
NPI assigned
Oct 2, 2006
Last updated
Mar 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A0335 OH Primary
Audiologist-Hearing Aid Fitter 237600000X A0335 OH

Addresses

Primary practice location

8897 Mentor Ave
Mentor, OH 44060-6211

Mailing address

8897 Mentor Ave
Mentor, OH 44060
Phone (216) 346-8083

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061030000184 OH Practitioner - Qualified Audiologist 8729085295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Audiology Concepts, Inc.Group PAC ID 2668479130, 3 clinicians

Practice addresses (Care Compare)

8897 Mentor Ave
Mentor, OH 44060-6211
Phone (440) 205-8848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A0335OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Audiology Concepts, Inc. Audiologist-Hearing Aid Fitter CurrentSince Oct 1, 2006 Accepting new patients

Locations

8897 Mentor Ave
Mentor, OH 44060
Phone (440) 205-8848

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1295828325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8897 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "44060",
            "telephone_number": "216-346-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8897 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440606211",
            "telephone_number": "440-205-8848",
            "fax_number": "440-205-9818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUKULA",
        "first_name": "JANE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "AU D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A0335",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "OH",
            "license": "A0335",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.