Individual provider Active NPI

Oleksiy Kulish, FNP

  • Family Nurse Practitioner
  • Sterling Heights, MI
National Provider Identifier
1609463769
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704310118 Issued in MI
Practice address
43620 Vintage Oaks Dr
Sterling Heights, MI 48314-2058
Phone
(248) 404-7196
NPI assigned
Dec 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704310118 MI Primary

Addresses

Primary practice location

43620 Vintage Oaks Dr
Sterling Heights, MI 48314-2058

Mailing address

43620 Vintage Oaks Dr
Sterling Heights, MI 48314-2058
Phone (248) 404-7196

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4704310118MIMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1609463769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43620 VINTAGE OAKS DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483142058",
            "telephone_number": "248-404-7196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43620 VINTAGE OAKS DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483142058",
            "telephone_number": "248-404-7196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULISH",
        "first_name": "OLEKSIY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-23",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704310118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.