Michael Lamar Kukulka

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71009326A Issued in IN

Practice address

1355 W Bloomfield Rd Ste 3
Bloomington, IN 47403-2051

Phone

(812) 200-2789

NPI assigned

Sep 6, 2019

Last updated

Aug 2, 2023By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, IL, OH, MI, NY, PA6 enrollments

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 6

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illinois Urgent Care Professionals PLLCGroup PAC ID 9830437946, 36 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Illinois Urgent Care Professionals PLLC

  dba Local MD Urgent Care

  • Family Medicine Physician
  • Homewood, IL
  • NPI 1215407812

  IN

  Medicare reassignment Care Compare group NPD
• Indiana University Health Southern Indiana Physicians, LLC

  • Multi-Specialty Clinic/Center
  • Bloomington, IN
  • NPI 1013953983
  Medicare reassignment NPD
• Pic Indiana PC

  dba WellNow Urgent Care

  • Urgent Care Clinic/Center
  • Mishawaka, IN
  • NPI 1942546890

  MI

  Medicare reassignment NPD
• Hometown Urgent Care of Michigan, P.C.

  dba Hometown Urgent Care

  • Urgent Care Clinic/Center
  • Huber Heights, OH
  • NPI 1790030385

  MI

  Medicare reassignment NPD
• Physicians Immediate Care North Chicago LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1205814118
  Medicare reassignment NPD
• Wellnow Urgent Care, PC

  dba WellNow Urgent Care

  • Urgent Care Clinic/Center
  • Liverpool, NY
  • NPI 1669825162

  IL, PA

  Medicare reassignment
• Hometown Urgent Care of Michigan, PC

  dba WellNow Clinical Laboratory

  • Clinical Medical Laboratory
  • Indianapolis, IN
  • NPI 1881358489
  NPD
• Indiana University Health Southern Indiana Physicians LLC

  • Durable Medical Equipment & Medical Supplies
  • Bloomington, IN
  • NPI 1063179844
  NPD
• Hometown Urgent Care of Michigan, P.C.

  dba WellNow Clinical Laboratory

  • Clinical Medical Laboratory
  • Kalamazoo, MI
  • NPI 1891469631
  NPD
• Community Health Providers PLLC

  • Family Medicine Physician
  • Homewood, IL
  • NPI 1184546467
  NPD (past)
• Wellnow Urgent Care Practice, PC

  dba WellNow Urgent Care

  • Urgent Care Clinic/Center
  • Rochester, NY
  • NPI 1013429752
  NPD (past)

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

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1356990915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 GLACIER ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995083772",
            "telephone_number": "907-843-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 W BLOOMFIELD RD STE 3",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032051",
            "telephone_number": "812-200-2789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 S Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474045296",
            "country_code": "US",
            "telephone_number": "812-778-3116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUKULKA",
        "first_name": "MICHAEL",
        "middle_name": "LAMAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-06",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "195749",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009326A",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71009326A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kroger Limited Partnership I (Kroger Pharmacy)
• Kroger Limited Partnership I (Kroger Pharmacy)
• Arthur Frederick Kruggel, M.S.
• Dian Sutor Krumlauf, MASSAGE THERAPIST
• Thomas Mark Kuhn, MSNANP
• Kavya Kumar, RBT
• Pooja Kumar, D.D.S
• Priya P. Kumar, MD
• Madison Theresa Kump, ATC, SCAT, NREMT
• John P Kunze, RBT

• Family Nurse Practitioner in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.
• 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.