NPIMap

Individual provider Active NPI

Cory Kukuvka, PT, DPT, CLT

  • Physical Therapist
  • Bethlehem, PA
National Provider Identifier
1700215902
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017875 Issued in PA
Practice address
1770 Bathgate Rd Ste 300
Bethlehem, PA 18017-7336
Phone
(484) 884-2251
NPI assigned
Nov 7, 2013
Sex
Female
Sole proprietor
Yes

Organizations & group practices 22

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.

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Hospital 54 clinicians

Practice addresses (Care Compare)

707 Hamilton St
FL 4
Allentown, PA 18101-2407
Phone (484) 862-3001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20211011001933 PA Practitioner - Physical Therapist in Private Practice 7517365208 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT017875PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Hospital Physical Therapist CurrentSince Oct 1, 2021 Accepting new patients
Lehigh Valley Hospital CurrentSince Oct 1, 2021 Accepting new patients
Lehigh Valley Hospital Muhlenberg Past Accepting new patients

Locations

707 Hamilton St
Fl 4
Allentown, PA 18101
Phone (484) 862-3001

2901 Emrick Blvd
Ste 103
Bethlehem, PA 18020
Phone (610) 625-2169

1770 Bathgate Rd
Ste 300
Bethlehem, PA 18017
Phone (484) 884-2251

700 Hawk Ridge Dr
Hamburg, PA 19526
Phone (610) 562-0170

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT017875 PA Primary

Addresses

NPPES NPI Registry

Primary practice location

1770 Bathgate Rd Ste 300
Bethlehem, PA 18017-7336

Mailing address

1770 Bathgate Rd Ste 300
Bethlehem, PA 18017-7336
Phone (484) 884-2251

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 7, 2013.

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1700215902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 BATHGATE RD STE 300",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177336",
            "telephone_number": "484-884-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 BATHGATE RD STE 300",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177336",
            "telephone_number": "484-884-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUKUVKA",
        "first_name": "CORY",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, CLT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT017875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.