Active NPI
Natalie Anna Kukulka, MD
- Neurology with Special Qualifications in Child Neurology Physician
- Salt Lake City, UT
National Provider Identifier
1639630528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology with Special Qualifications in Child Neurology Physician
- License
- 14236899-1205
- Practice address
- 81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125 - Phone
- (801) 662-1000
- NPI assigned
- Mar 25, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | 14236899-1205 | UT | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 14236899-1205 | UT |
Addresses
Primary practice location
81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125
Mailing address
PO Box 30180
Salt Lake City, UT 84130-0180
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark LLC/ Office Ally |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 299
Salt Lake City, UT 84110
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14236899-1205 | UT | MD | Neurology with Special Qualifications in Child Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Past | Accepting new patients | |
| University of Utah Pediatric Services | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Pediatrics Physician
- Salt Lake City, UT
- NPI 1487018974
-
- Multi-Specialty Clinic/Center
- Orem, UT
- NPI 1588601124
-
- Pediatrics Physician
- Riverton, UT
- NPI 1043671985
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762905600000",
"number": "1639630528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30180",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841300180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "81 N MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131125",
"telephone_number": "801-662-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUKULKA",
"first_name": "NATALIE",
"middle_name": "ANNA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-25",
"last_updated": "2025-11-12",
"certification_date": "2025-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "UT",
"license": "14236899-1205",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "UT",
"license": "14236899-1205",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.2019.3",
"affiliationName": "Bluemark LLC/ Office Ally",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "1300 SE Cardinal Ct Ste 190",
"city": "Vancouver",
"state": "WA",
"country_code": "US",
"postal_code": "986839683",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; 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.