Active NPI
John R Kuczynski, M.D.
- Gastroenterology Physician
- Olympia, WA
National Provider Identifier
1497897771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- MD60202111
- Practice address
- 406A Black Hills LN SW
Olympia, WA 98502 - Phone
- (360) 754-1735
- Fax
- (360) 704-3404
- NPI assigned
- Feb 13, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 76493 | AZ | |
| Gastroenterology Physician | 207RG0100X | MD60202111 | WA | Primary |
Addresses
Primary practice location
406A Black Hills LN SW
Olympia, WA 98502
Mailing address
406A Black Hills LN SW
Olympia, WA 98502
Phone (360) 754-1735
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110721000809 | WA | Practitioner - Gastroenterology | 0941300057 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Southern Illinois University School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Olympia Multi Specialty Clinic
Practice addresses (Care Compare)
3920 Capital Mall Dr SW
Suite 302
Olympia, WA 98502-8701
Phone (360) 704-3400
Hospital & facility affiliations
- Capital Medical Center
- Providence Centralia Hospital
- Summit Pacific Medical Center
- Willapa Harbor Hospital
- Mason General Hospital & Family of Clinics
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 162 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 253 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 76493 | AZ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Olympia Multi Specialty Clinic | Current | Accepting new patients | |
| Hospitalists of Arizona, Inc | Internal Medicine | Past | Accepting new patients |
Locations
406 Black Hills Ln SW
Ste A
Olympia, WA 98502
Phone (360) 754-1727
3920 Capital Mall Dr SW
Ste 302
Olympia, WA 98502
Phone (360) 561-6435
Organizations & group practices 2
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.
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Elma, WA
- NPI 1740211028
Hospital
-
- General Acute Care Hospital
- Centralia, WA
- NPI 1376624981
Hospital
-
- Critical Access Hospital
- Shelton, WA
- NPI 1760568752
Hospital
-
- Foot & Ankle Surgery Podiatrist
- Shelton, WA
- NPI 1437486248
Hospital
-
- Surgery Physician
- Shelton, WA
- NPI 1639339666
Hospital
-
- Ophthalmologic Surgery Clinic/Center
- Shelton, WA
- NPI 1922196609
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332806400000",
"number": "1497897771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "406A BLACK HILLS LN SW",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "98502",
"telephone_number": "360-754-1735",
"fax_number": "360-704-3404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "406A BLACK HILLS LN SW",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "98502",
"telephone_number": "360-754-1735",
"fax_number": "360-704-3404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUCZYNSKI",
"first_name": "JOHN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2012-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "76493",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "WA",
"license": "MD60202111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.