Active NPI
Casey Jordan Kukielski, MD
- Anesthesiology Physician
- Charlottesville, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 0101278438
- Practice address
- 1215 Lee St
Charlottesville, VA 22908-1544 - Phone
- (434) 924-2283
- Fax
- (434) 982-0019
- NPI assigned
- Mar 20, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 0116037519 | VA | |
| Anesthesiology Physician | 207L00000X | 0101278438 | VA | Primary |
| Anesthesiology Physician | 207L00000X | 99712 | GA |
Addresses
Primary practice location
1215 Lee St
Charlottesville, VA 22908-1544
Mailing address
PO Box 9007
Charlottesville, VA 22906-9007
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- University of Miami, LM Miller School of Medicine, 2019
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2068
Phone (770) 732-4022
2540 Windy Hill Rd
Marietta, GA 30067-8605
Phone (770) 644-1570
2540 Windy Hill Serd
Marietta, GA 30067-8605
Phone (770) 644-1274
2550 Windy Hill Rd SE
Suite 220
Marietta, GA 30067-8605
Phone (404) 321-9900
3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 702-1806
5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222
625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004
677 Church Nest
Marietta, GA 30060-1101
677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.45 of 100
- Quality
- 79.76
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.07
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10934 | GA | MD | General Practice Dentistry |
| 0116037519 | VA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients |
Locations
3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435
3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500
Organizations & group practices 3
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.
-
dba WellStar Family Medicine ACW
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Anesthesiology Physician
- Kennesaw, GA
- NPI 1912452939
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Wellstar Cobb Hospital
- General Acute Care Hospital
- Austell, GA
- NPI 1467420448
-
dba Wellstar Kennestone Hospital
- General Acute Care Hospital
- Marietta, GA
- NPI 1649248626
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788220800000",
"number": "1750841565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9007",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229069007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 LEE ST",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229081544",
"telephone_number": "434-924-2283",
"fax_number": "434-982-0019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUKIELSKI",
"first_name": "CASEY",
"middle_name": "JORDAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-20",
"last_updated": "2026-09-01",
"certification_date": "2026-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "VA",
"license": "0116037519",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "VA",
"license": "0101278438",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "GA",
"license": "99712",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlottesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; 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.