Active NPI
Kathleen L. Kulisek, D.M.D.
- Dentist
- Erie, PA
National Provider Identifier
1437268463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS024652L
- Practice address
- 1611 Peach Street
Suite 210
Erie, PA 16501 - Phone
- (814) 454-0001
- Fax
- (814) 454-0025
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | DS024652L | PA | Primary |
Addresses
Primary practice location
1611 Peach Street
Suite 210
Erie, PA 16501
Mailing address
1611 Peach Street
Suite 210
Erie, PA 16501
Phone (814) 454-0001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160614000814 | PA | Order and Referring Only - Other (Physician) | 6406147933 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471824000000",
"number": "1437268463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611 PEACH STREET",
"address_2": "SUITE 210",
"city": "ERIE",
"state": "PA",
"postal_code": "16501",
"telephone_number": "814-454-0001",
"fax_number": "814-454-0025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 PEACH STREET",
"address_2": "SUITE 210",
"city": "ERIE",
"state": "PA",
"postal_code": "16501",
"telephone_number": "814-454-0001",
"fax_number": "814-454-0025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KULISEK",
"first_name": "KATHLEEN",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2016-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS024652L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; 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.