Angela Kuklewski, NURSE PRACTITIONER

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

4704229854 Issued in MI

Practice address

600 Monroe Avenue NW
Ste 104
Grand Rapids, MI 49503-1470

Phone

(616) 366-4234

Fax

(855) 548-4481

NPI assigned

May 11, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Complexcare Medical Group Midwest H PLLCGroup PAC ID 0143737148, 128 clinicians

Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

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.

• Complexcare Medical Group Midwest H PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1457144933
  Medicare reassignment Care Compare group NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375
  Medicare reassignment Care Compare group NPD
• Careconnectmd Michigan PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Dearborn, MI
  • NPI 1477288348
  Medicare reassignment NPD
• Careline Hmi300 LLC

  • Community Based Hospice Care Agency
  • Grand Rapids, MI
  • NPI 1770257818
  NPD (past)
• Iah of Michigan, PLLC

  • Family Medicine Physician
  • Troy, MI
  • NPI 1578969705
  NPD (past)
• Mobile Physician Services Inc.

  • Internal Medicine Physician
  • New Port Richey, FL
  • NPI 1003002759
  NPD (past)

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1578941571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8348 LITTLE ROAD",
            "address_2": "STE 149",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346544919",
            "telephone_number": "616-366-4234",
            "fax_number": "855-548-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MONROE AVENUE NW",
            "address_2": "STE 104",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031470",
            "telephone_number": "616-366-4234",
            "fax_number": "855-548-4481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Monroe Avenue NW",
            "address_2": "Ste 104",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495031470",
            "country_code": "US",
            "telephone_number": "616-366-4234",
            "fax_number": "855-548-4481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUKLEWSKI",
        "first_name": "ANGELA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704229854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corwyn Kuipers
• Jessica Kuipers, DPT
• Katie Kuipers, FNP-C
• Faeq R Kukhon, M.D.
• Nicole E Kukla, MSW
• Andrea S Kuldanek, MD
• Terri Lynn Kulhanek
• Bailey A Kulich
• Matthew D Kulie, DO
• Chintan Anil Kulkarni

• Primary Care Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Primary Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.