Carol Kucel, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-1724 Issued in ID

Practice address

1770 Front St
#230
Lynden, WA 98264-2103

Phone

(702) 250-7090

NPI assigned

Feb 18, 2010

Last updated

May 14, 2019By the provider in NPPES

Sex

Female

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Icco, LLC

  dba BestMed

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1407004757
  Medicare reassignment NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Cep America, LLC

  dba Vituity

  • Emergency Medicine Physician
  • Eagle, ID
  • NPI 1700246915
  NPD
• Icco LLC

  dba BestMed

  • Rural Health Clinic/Center
  • Florence, OR
  • NPI 1740896547
  NPD
• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  NPD

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1588986533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 FRONT STREET",
            "address_2": "#230",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "98264",
            "telephone_number": "702-250-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 FRONT ST",
            "address_2": "#230",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982642103",
            "telephone_number": "702-250-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCEL",
        "first_name": "CAROL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-18",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60129908",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Duane Korthuis, ATC
• Jeremy Jacob Korthuis, DPT
• Steven Kenneth Korthuis, DPT
• Marilyn R. Korver, PT
• Amber Michelle Kreiger, L.AC.
• Melodie Langstraat, PTA
• Shannon A Lanskis, DPT
• Colleen Virginia Lee, LMHC
• Junghee Lee, DC
• Jessica Lynn Libolt, L.M.P.

• Physician Assistant in Lynden, WA
• Providers in Lynden, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.