Active NPI
Michael V Kulisz
- Psychiatric/Mental Health Nurse Practitioner
- Springfield, MA
National Provider Identifier
1417719253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- RN2332285
- Practice address
- 95 Frank B Murray St
Springfield, MA 01103-1106 - Phone
- (413) 210-1689
- NPI assigned
- Jan 26, 2024
- Last updated
- Jan 26, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN2332285 | MA | Primary |
Addresses
Primary practice location
95 Frank B Murray St
Springfield, MA 01103-1106
Mailing address
48 Colonial Cir Unit D
Chicopee, MA 01020-1949
Phone (413) 210-1689
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2332285 | MA | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706227200000",
"number": "1417719253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48 COLONIAL CIR UNIT D",
"city": "CHICOPEE",
"state": "MA",
"postal_code": "010201949",
"telephone_number": "413-210-1689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 FRANK B MURRAY ST",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011031106",
"telephone_number": "413-210-1689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KULISZ",
"first_name": "MICHAEL",
"middle_name": "V",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-01-26",
"last_updated": "2024-01-26",
"certification_date": "2024-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MA",
"license": "RN2332285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.