Amy Kulak, MD

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

ME116872 Issued in FL

Practice address

530 Jacksonville Dr
Jacksonville Beach, FL 32250-3813

Phone

(904) 775-5275

Fax

(904) 853-1414

NPI assigned

Sep 12, 2008

Last updated

Jan 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 FL

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 1

Specialty

Ophthalmology

Education

University of Miami, LM Miller School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amy.kulak.p3@direct.theeyeassociates.nextgenshare.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.

• Kulak Oculofacial LLC

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Jacksonville Beach, FL
  • NPI 1013681774

  Ophthalmology

  Medicare reassignment NPD Authorized official
• Russell Stackhouse MD PA

  dba Coastal Vision Center

  • Ophthalmology Physician
  • Fernandina, FL
  • NPI 1538655014
  Medicare reassignment NPD
• Southpoint Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Jacksonville, FL
  • NPI 1477500767
  NPD (past)

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1689823783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 JACKSONVILLE DR",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503813",
            "telephone_number": "904-775-5275",
            "fax_number": "904-853-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 JACKSONVILLE DR",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503813",
            "telephone_number": "904-775-5275",
            "fax_number": "904-853-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULAK",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-12",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME116872",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME116872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Kordonowy, MA
• Michelle M Krawczyk, ARNP
• Angela Mahoney Kreidl, MS OTRL
• Michael D Kring, PA
• Kulak Oculofacial LLC
• Lillian Kendall Kulik, PA-C
• La Quinn MD PA
• La Quinn MD PA
• Efstratios Demetrios Lagoutaris, DPM
• Ludina Laguerre

• Ophthalmic Plastic and Reconstructive Surgery Physician in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; 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.