Kelly D Pucek, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MD30606 Issued in TN

Practice address

24 Physicians Dr
Jackson, TN 38305-2070

Phone

(731) 661-9825

Fax

(731) 668-6757

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Orthopedic Surgery

Education

University of Arkansas College of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health Facilities Rehab Services IncGroup PAC ID 3476679226, 152 clinicians

West Tennessee Bone and Joint Clinic PCGroup PAC ID 7517940182, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Care Home health agency, Jackson, TN, CCN 447278
• Medical Center Home Health LLC Home health agency, Jackson, TN, CCN 447101
• Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
• Baptist Memorial Hospital - Carroll County Hospital, Huntingdon, TN, CCN 440016

Merit-based Incentive Payment System (MIPS)

Final score

91.05 of 100Reported as group

Promoting interoperability

98

Improvement activities

40

Cost

73.85

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.pucek.1@3533.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 and National Provider Directory roles.

• West Tennessee Bone and Joint Clinic PC

  • Specialist
  • Jackson, TN
  • NPI 1831312461

  Orthopaedic Surgery

  Medicare reassignment Care Compare group NPD
• Health Facilities Rehab Services Inc

  • Rehabilitation Clinic/Center
  • Sikeston, MO
  • NPI 1720003551
  Care Compare group

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

• Baptist Memorial Hospital-Huntingdon

  • General Acute Care Hospital
  • Huntingdon, TN
  • NPI 1710941356
  Care Compare affiliation
• HHC, LLC

  • Home Health Agency
  • Jackson, TN
  • NPI 1851349559
  Care Compare affiliation
• Jackson Madison County General Hospital

  • General Acute Care Hospital
  • Jackson, TN
  • NPI 1093705428
  Care Compare affiliation
• Medical Center Home Health, LLC

  • Home Health Agency
  • Jackson, TN
  • NPI 1932355997
  Care Compare affiliation

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1710086335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052070",
            "telephone_number": "731-661-9825",
            "fax_number": "731-668-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052070",
            "telephone_number": "731-661-9825",
            "fax_number": "731-668-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCEK",
        "first_name": "KELLY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "MD30606",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TN",
            "license": "MD30606",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q010037",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Professional Anesthesia Associates
• Professional Health Services of Jackson
• Professional Respiratory Services
• Brittany Ann Proudfit, FNP-C
• Psychological Services
• Sarah Y Pucek, CRNA
• Delaney Puckett, DO
• Tracey Renee Puckett, PMHNP-BC
• Jennifer Neicole Puente, NP
• Elisabeth Jane Pueschel, P.A.

• Orthopaedic Surgery Physician in Jackson, TN
• Providers in Jackson, TN by specialty
• Orthopaedic Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; 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.