NPIMap

Individual provider Active NPI

Gilbert L Kukielka, MD

  • Interventional Cardiology Physician
  • Cape Girardeau, MO
National Provider Identifier
1710986427
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
2020012709 Issued in MO
Practice address
211 Saint Francis Dr Ste 15
Cape Girardeau, MO 63703-5049
Phone
(573) 331-3333
Fax
(573) 331-3334
NPI assigned
Jul 15, 2005
Last updated
Aug 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 2020012709 MO
Interventional Cardiology Physician 207RI0011X 2020012709 MO Primary

Addresses

Primary practice location

211 Saint Francis Dr Ste 15
Cape Girardeau, MO 63703-5049

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200528003231 MO Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 4385639103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians

Practice addresses (Care Compare)

434 N W St
Perry County Memorial Hospital
Perryville, MO 63775-1398
Phone (573) 547-2536

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
67.07 of 100Reported as apm
Quality
85.4
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2020012709MOMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center Current Accepting new patients
Saint Francis Medical Center CurrentSince Jul 1, 2020 Accepting new patients
Cape Laboratory & Pathology, LC Current Accepting new patients
Saint Francis Medical Center CurrentSince Jul 1, 2020 Accepting new patients
Ferguson Medical Group Rural Health Center Inc. Past Accepting new patients
Osu Internal Medicine, LLC Past Accepting new patients

Locations

211 Saint Francis Dr
Ste 15
Cape Girardeau, MO 63703
Phone (573) 331-3333

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

434 N West St
Perryville, MO 63775
Phone (573) 547-2530

Interoperability endpoints

  • Direct secure messaging: gkukielka95408@surescripts.sfmc.net

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1710986427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 SAINT FRANCIS DR STE 15",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035049",
            "telephone_number": "573-331-3333",
            "fax_number": "573-331-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUKIELKA",
        "first_name": "GILBERT",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2020012709",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MO",
            "license": "2020012709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.