Individual provider Active NPI

Michelle Kukielski, PA-C

  • Physician Assistant
  • Plano, TX
National Provider Identifier
1578053013
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA11937 Issued in TX
Practice address
3108 Midway Rd Ste 104
Plano, TX 75093-8485
Phone
(972) 398-0393
Fax
(972) 398-0499
NPI assigned
May 10, 2018
Last updated
May 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA11937 TX Primary

Addresses

Primary practice location

3108 Midway Rd Ste 104
Plano, TX 75093-8485

Mailing address

3108 Midway Rd Ste 104
Plano, TX 75093-8485
Phone (972) 398-0393

Other practice location 1

5800 Communications Pkwy
Plano, TX 75093-7882
Phone (972) 265-4190

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180726001559 TX Practitioner - Physician Assistant 6103173885 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3242 Preston Rd
Suite 200
Plano, TX 75093-3328
Phone (972) 867-0019

5425 W Spring Creek Pkwy
Suite 205
Plano, TX 75024-4236
Phone (972) 526-5860

5800 Communications Pkwy
Plano, TX 75093-7882
Phone (972) 265-4190

7150 N President George Bush Hwy
Suite 201
Garland, TX 75044-2210
Phone (972) 771-2222

P O Box
Suite 35629
Dallas, TX 75235-0629

PO Box
Suite 35629
Dallas, TX 75235-0629

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
66.51
Promoting interoperability
98
Improvement activities
40
Cost
71.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA11937TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Nov 12, 2018 Accepting new patients
Texas Digestive Disease Consultants PLLC CurrentSince Apr 18, 2022 Accepting new patients
Texas Digestive Disease Consultants, PLLC CurrentSince Apr 18, 2022 Accepting new patients
Texas Health Physicians Group CurrentSince Nov 12, 2018 Accepting new patients
Texas Digestive Disease Consultants, PLLC Past Accepting new patients

Locations

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

3108 Midway Rd
Ste 104
Plano, TX 75093
Phone (214) 731-3008

3242 Preston Rd
Ste 200
Plano, TX 75093
Phone (972) 867-0019

5425 W Spring Creek Pkwy
Ste 205
Plano, TX 75024
Phone (972) 526-5860

5800 Communications Pkwy
Plano, TX 75093
Phone (972) 265-4190

6124 W Parker Rd
Ste 336
Plano, TX 75093
Phone (972) 403-3100

6124 W Parker Rd
Ste 338
Plano, TX 75093
Phone (972) 608-8979

Organizations & group practices 7

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.

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": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1578053013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 MIDWAY RD STE 104",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938485",
            "telephone_number": "972-398-0393",
            "fax_number": "972-398-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 MIDWAY RD STE 104",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938485",
            "telephone_number": "972-398-0393",
            "fax_number": "972-398-0499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5800 Communications Pkwy",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750937882",
            "country_code": "US",
            "telephone_number": "972-265-4190",
            "fax_number": "972-265-4189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUKIELSKI",
        "first_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-10",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.