Individual provider Active NPI

Eric S Kucera, DC

  • Chiropractor
  • East Bernard, TX
National Provider Identifier
1770690166
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC7950 Issued in TX
Practice address
1131 A Main
East Bernard, TX 77435-9227
Phone
(979) 335-4500
Fax
(979) 335-4545
NPI assigned
Aug 23, 2006
Last updated
May 13, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC7950 TX Primary

Addresses

Primary practice location

1131 A Main
East Bernard, TX 77435-9227

Mailing address

107 Live Oak Dr
Van Vleck, TX 77482-9764
Phone (979) 335-4500

Other identifiers 3

IdentifierTypeStateIssuer
DC7950OtherTXWC
605855OtherTXBCBS
P00379816OtherTXRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051227000113 TX Practitioner - Chiropractic 1658393384 Practice locations: East Bernard, TX

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

891 Seydler
East Bernard, TX 77435-7488
Phone (979) 335-4500

891 Seydler St
East Bernard, TX 77435-7488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC7950TXMDChiropractor

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1770690166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 LIVE OAK DR",
            "city": "VAN VLECK",
            "state": "TX",
            "postal_code": "774829764",
            "telephone_number": "979-335-4500",
            "fax_number": "979-335-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 A MAIN",
            "city": "EAST BERNARD",
            "state": "TX",
            "postal_code": "774359227",
            "telephone_number": "979-335-4500",
            "fax_number": "979-335-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCERA",
        "first_name": "ERIC",
        "middle_name": "S",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "DC7950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WC",
            "identifier": "DC7950",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "605855",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00379816",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Bernard, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.