Individual provider Active NPI

Conor Kuczka, PA-C

  • Physician Assistant
  • Longmont, CO
National Provider Identifier
1760174643
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2030 Mountain View Ave Ste 420
Longmont, CO 80501-3182
Phone
(303) 776-9400
NPI assigned
May 22, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

2030 Mountain View Ave Ste 420
Longmont, CO 80501-3182

Mailing address

25 Crossroads Dr Ste 306
Owings Mills, MD 21117-5437
Phone (303) 695-6106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231027003422 CO Practitioner - Physician Assistant 0840646790 Reassigns benefits to 1 organization
I20250319001761 IL Practitioner - Physician Assistant 0840646790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1411 S Michigan Ave
Chicago, IL 60605-2810

1620 W Harrison St
Chicago, IL 60612-3801

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

1725 W Harrison St
Suite 955
Chicago, IL 60612-3862
Phone (312) 942-7030

1725 W Harrison St
Suite 970
Chicago, IL 60612-3828
Phone (312) 563-3447

Hospital & facility affiliations

  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119
  • Rush Oak Park Hospital Hospital, Oak Park, IL, CCN 140063

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Urology, PLLC Single Specialty Current Accepting new patients
Rush University Medical Group Single Specialty CurrentSince Mar 14, 2025 Accepting new patients
Advanced Urology, PLLC CurrentSince Oct 23, 2023 Accepting new patients

Locations

32135 Castle Ct
Ste 101
Evergreen, CO 80439
Phone (303) 679-8500

2030 Mountain View Ave
Ste 420
Longmont, CO 80501
Phone (303) 776-9400

1411 S Michigan Ave
Fl 5
Chicago, IL 60605
Phone (312) 454-2700

1725 W Harrison St
Ste 970
Chicago, IL 60612
Phone (312) 563-3447

1725 W Harrison St
Ste 955
Chicago, IL 60612
Phone (312) 563-3700

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

610 S Maple Ave
Ste 3450
Oak Park, IL 60304
Phone (312) 563-3447

25 Crossroads Dr
Ste 306
Owings Mills, MD 21117
Phone (443) 231-1681

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.

Hospital & facility affiliations 3

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": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1760174643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CROSSROADS DR STE 306",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175437",
            "telephone_number": "303-695-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 MOUNTAIN VIEW AVE STE 420",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013182",
            "telephone_number": "303-776-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCZKA",
        "first_name": "CONOR",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.