Benjamin Kukull, MD

Primary specialty

Molecular Genetic Pathology (Pathology) PhysicianTaxonomy code 207ZP0007X

License

11184892-1205 Issued in UT

Practice address

15 Medical Dr Ste 1100
Salt Lake City, UT 84112-1100

Phone

(801) 581-4390

NPI assigned

Apr 10, 2015

Last updated

Jun 11, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Pathology

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Pathology Associates IncGroup PAC ID 1951399484, 16 clinicians

Cascade Pathology Services CorpGroup PAC ID 4981693215, shared by 2 NPIs, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
• Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
• Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150
• Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025
• Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pacific Pathology Associates, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Salem, OR
  • NPI 1205997889
  Medicare reassignment Care Compare group NPD
• Cascade Pathology Services, Corp

  • Anatomic Pathology & Clinical Pathology Physician
  • Portland, OR
  • NPI 1154465656
  Medicare reassignment NPD
• Cascade Pathology Services, Corp

  • Anatomic Pathology & Clinical Pathology Physician
  • Vancouver, WA
  • NPI 1568618239
  Medicare reassignment NPD
• Austin Pathology Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Austin, TX
  • NPI 1538172028
  NPD
• Austin Pathology Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Austin, TX
  • NPI 1669414330
  NPD (past)

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

• Legacy Emanuel Hospital & Health Center

  dba Unity Center for Behavioral Health-PES

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003367491
  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  dba Legacy Laboratory Services

  • Clinical Medical Laboratory
  • Portland, OR
  • NPI 1295756898

  Hospital

  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • Clinic/Center
  • Portland, OR
  • NPI 1700809027

  Hospital

  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358
  Care Compare affiliation
• Legacy Good Samaritan Hospital and Medical Center

  dba Legacy Good Samaritan Providers

  • Clinic/Center
  • Portland, OR
  • NPI 1679597108

  Hospital

  Care Compare affiliation
• Legacy Good Samaritan Hospital and Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1780608216
  Care Compare affiliation
• Legacy Meridian Park Hospital

  • General Acute Care Hospital
  • Tualatin, OR
  • NPI 1184647620
  Care Compare affiliation
• Legacy Mount Hood Medical Center

  • General Acute Care Hospital
  • Gresham, OR
  • NPI 1255354700
  Care Compare affiliation
• Legacy Salmon Creek Hospital

  dba Legacy Salmon Creek Providers

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784

  Hospital

  Care Compare affiliation
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  Care Compare affiliation

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1588050157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MEDICAL DR STE 1100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841121100",
            "telephone_number": "801-581-4390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MEDICAL DR STE 1100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841121100",
            "telephone_number": "801-581-4390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-494-8211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUKULL",
        "first_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-10",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0007X",
            "taxonomy_group": "",
            "desc": "Pathology, Molecular Genetic Pathology",
            "state": "UT",
            "license": "11184892-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gilbert Francis Kuhn
• Kelby Kuhn, PHARMD
• Audra Kujaczynski
• Taylor Kujawa, PHARMD
• Natalie Anna Kukulka, MD
• Heidi Kulicke
• Anca Kulikov, DPT
• Doreen Bianchi Kulikowski, PHARMD.
• Douglas Kulikowski
• Jennilyn Kulikowski

• Molecular Genetic Pathology (Pathology) Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Molecular Genetic Pathology (Pathology) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.