Cullen Burgess Kubicki, APRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

23889 Issued in SC

Practice address

1053 Center Street
SC House Calls Inc
West Columbia, SC 29169

Phone

(800) 491-0909

NPI assigned

May 26, 2020

Last updated

Oct 21, 2020By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hilton Head Regional Physician Group LLCGroup PAC ID 9234573676, 114 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Hilton Head Medical Center Hospital, Hilton Head Island, SC, CCN 420080
• Coastal Carolina Hospital Hospital, Hardeeville, SC, CCN 420101
• Beaufort County Memorial Hospital Hospital, Beaufort, SC, CCN 420067

Merit-based Incentive Payment System (MIPS)

Final score

79.72 of 100Reported as group

Quality

63.11

Promoting interoperability

100

Improvement activities

40

Cost

69.3

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cullen.kubicki.1@30548.direct.athenahealth.com

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.

• Hilton Head Regional Physician Group LLC

  • Internal Medicine Physician
  • Bluffton, SC
  • NPI 1548021694
  Medicare reassignment Care Compare group NPD
• Hilton Head Regional Physician Group LLC

  dba Wound Healing Center

  • Surgery Physician
  • Bluffton, SC
  • NPI 1295596708
  NPD
• Hilton Head Regional Physician Group LLC

  • Surgery Physician
  • Bluffton, SC
  • NPI 1124889639
  NPD (past)

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

• Beaufort County Memorial Hospital

  • General Acute Care Hospital
  • Beaufort, SC
  • NPI 1366436073
  Care Compare affiliation
• Hilton Head Medical Center LLC

  dba Novant Health Hilton Head Medical Center

  • General Acute Care Hospital
  • Hilton Head Island, SC
  • NPI 1902675101
  Care Compare affiliation
• South Carolina Coastal Medical Center LLC

  dba Novant Health Coastal Carolina Hospital

  • General Acute Care Hospital
  • Hardeeville, SC
  • NPI 1205605409
  Care Compare affiliation

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1609499623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1053 CENTER STREET",
            "address_2": "SC HOUSE CALLS INC",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "29169",
            "telephone_number": "800-491-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1053 CENTER STREET",
            "address_2": "SC HOUSE CALLS INC",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "29169",
            "telephone_number": "800-491-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBICKI",
        "first_name": "CULLEN",
        "middle_name": "BURGESS",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "23889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Nicole Krell
• Mary Katherine Krell
• Madison Krouse
• Jillian M. Krueger, COTA/L
• David E Krusling, MD
• Parthivkumar N Kundaria, M.D.
• Adrienne Kupper
• Gayatri Kuraganti, M.D.
• Alexander Kurtz, PA-C
• Kimberlee Ann Kyzer, PTA

• Gerontology Nurse Practitioner in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Gerontology Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.