Michael Kulisz, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Practice address

626 Bethany Rd
Dekalb, IL 60115-4939

Phone

(815) 756-1521

NPI assigned

Jan 23, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL, WI2 enrollments

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 2

Specialty

Emergency Medicine

Education

Chicago College of Osteopathy, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Wisconsin Emergency Associates SCGroup PAC ID 3274561055, 47 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beloit Health System Hospital, Beloit, WI, CCN 520100
• Fort Memorial Hospital Hospital, Fort Atkinson, WI, CCN 520071

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Southern Wisconsin Emergency Associates SC

  • Emergency Medicine Physician
  • Beloit, WI
  • NPI 1568538189

  IL

  Medicare reassignment Care Compare group NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  IL

  Medicare reassignment NPD
• Swea Fort SC

  • Emergency Medicine Physician
  • Fort Atkinson, WI
  • NPI 1295552065
  Medicare reassignment NPD
• Kishwaukee Community Hospital

  dba Northwestern Medicine Kishwaukee Hospital

  • General Acute Care Hospital
  • Dekalb, IL
  • NPI 1669534517
  NPD (past)

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

• Beloit Health System Inc

  dba Beloit Memorial Hospital

  • General Acute Care Hospital
  • Beloit, WI
  • NPI 1982780094
  Care Compare affiliation
• Fort Healthcare Inc

  • Otolaryngology Physician
  • Fort Atkinson, WI
  • NPI 1417993361

  Hospital

  Care Compare affiliation
• Fort Healthcare, Inc.

  • General Acute Care Hospital
  • Fort Atkinson, WI
  • NPI 1811916281
  Care Compare affiliation

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1760536700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2807 BRITTANY CT",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601755161",
            "telephone_number": "630-377-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 BETHANY RD",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601154939",
            "telephone_number": "815-756-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULISZ",
        "first_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "098603",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Kyle Kroma, LSW
• Daniel Krout
• William C Kruzan, DDS
• Suzanne Marie Krzyzek, LCPC
• Matthew David Kuehl, ATC
• Lauren Laake Devlieger, PHD
• Teresa Lacek, CRNA
• Ashley Marie Lambert, MSAT, ATC, LAT
• Brian David Lamere, MD
• Mary Lampson, LCSW

• Emergency Medicine Physician in Dekalb, IL
• Providers in Dekalb, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.