NPIMap

Individual provider Active NPI

Shanna Kulick, CRNP

  • Family Nurse Practitioner
  • Hazleton, PA
National Provider Identifier
1578233102
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP024627 Issued in PA
Practice address
1000 Alliance Dr
Hazleton, PA 18202-3234
Phone
(570) 459-2226
Fax
(570) 459-2511
NPI assigned
Sep 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP024627 PA
Family Nurse Practitioner 363LF0000X SP024627 PA Primary

Addresses

Primary practice location

1000 Alliance Dr
Hazleton, PA 18202-3234

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622
Phone (570) 501-6368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211110000037 PA Practitioner - Nurse Practitioner 5597154716 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1000 Alliance Dr
Suite 1
Hazleton, PA 18202-3234
Phone (570) 459-2226

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.5 of 100Reported as group
Quality
66.14
Promoting interoperability
85
Improvement activities
40
Cost
74.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP024627PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Nurse Practitioner Current Accepting new patients
Hazleton Professional Services Nurse Practitioner CurrentSince Nov 1, 2021 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2025 Accepting new patients
Lehigh Valley Physician Group CurrentSince Nov 1, 2021 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2025 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

2100 Mack Blvd
Allentown, PA 18103
Phone (484) 224-1892

2100 Mack Blvd
Fl 4
Allentown, PA 18103

1000 Alliance Dr
Hazleton, PA 18202
Phone (570) 501-6400

1000 Alliance Dr
#1
Hazleton, PA 18202
Phone (570) 459-2226

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

Interoperability endpoints

  • Direct secure messaging: skulick180602@direct2.lvhn.org

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1578233102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "570-501-6368",
            "fax_number": "570-501-4754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ALLIANCE DR",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182023234",
            "telephone_number": "570-459-2226",
            "fax_number": "570-459-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULICK",
        "first_name": "SHANNA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP024627",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP024627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazleton, PA

Sources for this page

Verify at the official NPI Registry.