Omotomike Kuku

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP130751 Issued in TX

Practice address

850 Central Pkwy E Ste 275
Plano, TX 75074-5542

Phone

(972) 881-4688

NPI assigned

Jun 13, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Villagehealth DM LLC 161 clinicians

Legacy Physiatry Group LLC 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, 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 and National Provider Directory roles.

• Legacy Physiatry Group LLC

  • Physical Medicine & Rehabilitation Physician
  • Plano, TX
  • NPI 1316078769

  TX

  Medicare reassignment Care Compare group NPD
• Villagehealth DM LLC

  • Case Management Agency
  • Denver, CO
  • NPI 1598273211

  TX

  Medicare reassignment Care Compare group
• Enriched Lives Health Services

  • Family Nurse Practitioner
  • Katy, TX
  • NPI 1538736384

  Family, TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1467802249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8011 RIPPLING STREAM LN",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774071427",
            "telephone_number": "832-287-8691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 CENTRAL PKWY E STE 275",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750745542",
            "telephone_number": "972-881-4688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8011 Rippling Stream Ln",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "TX",
            "postal_code": "774071427",
            "country_code": "US",
            "telephone_number": "832-287-8691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUKU",
        "first_name": "OMOTOMIKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP130751",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "TX",
            "license": "791355",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Erich Kubala, M.D.
• Tracy Brooke Kubena Coffman
• Shanae Audryonna Kubik
• Kuki Chiropractic LLC
• Michelle Kukielski, PA-C
• Kathryn Kula, LMFT-A
• Izmit Kulafofski, D.C.
• Anandita Kulkarni, MD
• Ansuya S Kumar, MD
• Jonni Kumar

• All providers in Plano, TX
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.