NPIMap

Individual provider Active NPI

Daniel Timothy Kulick, DO

  • Family Medicine Physician
  • Brown City, MI
National Provider Identifier
1720206600
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101016234 Issued in MI
Practice address
4472 Main St
Brown City, MI 48416-7908
Phone
(810) 346-2751
NPI assigned
Apr 23, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101016234 MI Primary

Addresses

Primary practice location

4472 Main St
Brown City, MI 48416-7908

Mailing address

4472 Main St
Brown City, MI 48416-7908
Phone (810) 346-2751

Other identifiers 4

IdentifierTypeStateIssuer
5101016234OtherMILICENSE
5315024530OtherMICONTROLLED SUBSTANCE LICENSE
11762285OtherMICAQH ID
1376695205OtherMIGROUP NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20070718000385 MI Practitioner - Family PracticePractitioner - Addiction Medicine 1456452671 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Addiction Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marlette Regional HospitalGroup PAC ID 3971408121, shared by 10 NPIs, 32 clinicians

Practice addresses (Care Compare)

4472 Main St
Brown City, MI 48416-7908
Phone (810) 346-2752

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hills & Dales General Hospital, Inc. Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Deckerville Community Hospital Inc Current Accepting new patients
Hills & Dales General Hospital, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Marlette Regional Hospital Past Accepting new patients
Daniel Kulick DO, P.C. Family Medicine PastSince Jul 1, 2012 Accepting new patients
Marlette Regional Hospital Past Accepting new patients

Locations

4675 Hill St
Cass City, MI 48726
Phone (989) 872-2121

2030 Black River St
Deckerville, MI 48427
Phone (810) 376-2835

Interoperability endpoints

  • Direct secure messaging: dkulick163906@direct.covenanthealthcare.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/i-zcCbJ35X2O5bJkqEF8dvUIAeQf3o9y/

Organizations & group practices 9

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 11

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1720206600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4472 MAIN ST",
            "city": "BROWN CITY",
            "state": "MI",
            "postal_code": "484167908",
            "telephone_number": "810-346-2751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4472 MAIN ST",
            "city": "BROWN CITY",
            "state": "MI",
            "postal_code": "484167908",
            "telephone_number": "810-346-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULICK",
        "first_name": "DANIEL",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101016234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "5101016234",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE LICENSE",
            "identifier": "5315024530",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "11762285",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1376695205",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brown City, MI

Sources for this page

Verify at the official NPI Registry.