Individual provider Active NPI

Deanna M Kulacz, MSN, RN-BC, AGNP-C

  • Adult Health Nurse Practitioner
  • Valhalla, NY
National Provider Identifier
1528587474
Registry record updated Jan 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F308365 Issued in NY
Practice address
61 Grasslands Rd
Valhalla, NY 10595-1543
Phone
(917) 499-3099
NPI assigned
Sep 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F308365 NY Primary

Addresses

Primary practice location

61 Grasslands Rd
Valhalla, NY 10595-1543

Mailing address

21 Stonewall Cir
West Harrison, NY 10604-1144
Phone (917) 499-3099

Other practice location 1

494 Elm St
Stamford, CT 06902-5115
Phone (917) 499-3099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20191015003181 CT Practitioner - Nurse Practitioner 3577820034 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HDC Care Solutions LLCGroup PAC ID 0345634770, 190 clinicians

Practice addresses (Care Compare)

101 Centerpoint Dr
Suite 215
Middletown, CT 06457-7568
Phone (888) 964-6681

Hospital & facility affiliations

  • Greenwich Hospital Association - Hospital, Greenwich, CT, CCN 070018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8376CTMDOrthodontics and Dentofacial Orthopedic Dentist
308365NYMDOrthopaedic Surgery Physician
F308365NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthdrive Medical Services Southeast LLC Adult Health CurrentSince Aug 1, 2025 Accepting new patients
Stella Medical Care LLC Adult Health CurrentSince Aug 13, 2019 Accepting new patients
HDC Care Solutions, LLC Adult Health CurrentSince Jan 1, 2025 Accepting new patients
Careconnectmd Connecticut PC CurrentSince Jan 16, 2025 Accepting new patients
Value Based Long Term Care H PC CurrentSince May 1, 2025 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

101 Centerpoint Dr
Ste 215
Middletown, CT 06457
Phone (203) 696-3550

5 Research Dr
Shelton, CT 06484
Phone (203) 567-5264

90 Morgan St
Ste 303
Stamford, CT 06905
Phone (203) 323-6873

1266 E Main St
Stamford, CT 06902
Phone (203) 276-3000

Organizations & group practices 5

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 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641600000000",
    "number": "1528587474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 STONEWALL CIR",
            "city": "WEST HARRISON",
            "state": "NY",
            "postal_code": "106041144",
            "telephone_number": "917-499-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 GRASSLANDS RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951543",
            "telephone_number": "917-499-3099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "494 Elm St",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "069025115",
            "country_code": "US",
            "telephone_number": "917-499-3099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KULACZ",
        "first_name": "DEANNA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MSN, RN-BC, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2022-01-08",
        "certification_date": "2022-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F308365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.