Jason Niles Kukas, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95023040 Issued in CA

Practice address

954 W Foothill Blvd Ste a
Upland, CA 91786-3782

Phone

(909) 846-4222

NPI assigned

Oct 26, 2022

Last updated

Oct 26, 2022By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Health Service AllianceGroup PAC ID 4587642467, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Health Service Alliance

  • Family Medicine Physician
  • Chino, CA
  • NPI 1801307368
  Medicare reassignment Care Compare group NPD
• Health Service Alliance

  dba Hesperia Community Health Center

  • Family Medicine Physician
  • Hesperia, CA
  • NPI 1689492167
  NPD
• Health Service Alliance

  • Psychologist
  • Claremont, CA
  • NPI 1720675986
  NPD

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1437876760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41500 WASHINGTON ST APT E224",
            "city": "BERMUDA DUNES",
            "state": "CA",
            "postal_code": "922039516",
            "telephone_number": "760-989-7608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 W FOOTHILL BLVD STE A",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863782",
            "telephone_number": "909-846-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUKAS",
        "first_name": "JASON",
        "middle_name": "NILES",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95023040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeyashree Krishnan, DDS
• Elena Krishtal, PSYD
• Joshua Michael Kruse, M.A., M.A.
• Daniel Kudo, PHARMD APH
• Gail Kudo, RN
• Sarina Kular, M.D.
• Daniel Masato Kunihira, DDS
• Mark Jeffrey Kunihira, D.D.S.
• Richard Yoshito Kunihira, D.D.S
• Yung Jen Kuo, FNP

• Psychiatric/Mental Health Nurse Practitioner in Upland, CA
• Providers in Upland, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.