Individual provider Active NPI

Nataliya Kukhar, MD

  • Family Medicine Physician
  • Moline, IL
National Provider Identifier
1780868604
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036124754 Issued in IL
Practice address
525 Valley View Dr
Moline, IL 61265-6138
Phone
(309) 762-9869
Fax
(309) 762-2313
NPI assigned
Dec 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 125053616 IL
Family Medicine Physician 207Q00000X 036124754 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X 036.124754 IL

Addresses

Primary practice location

525 Valley View Dr
Moline, IL 61265-6138

Mailing address

525 Valley View Dr
Moline, IL 61265-6138
Phone (309) 762-9869

Other identifiers 2

IdentifierTypeStateIssuer
1780868604MedicaidIL
P01019756OtherILRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 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

Enrollment IDStateProvider typePAC IDDetails
I20110818000789 IL Practitioner - Family Practice 0941470454 Reassigns benefits to 1 organization
I20211019001351 IA Practitioner - Family Practice 0941470454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

4480 Utica Ridge Rd
Suite 2230
Bettendorf, IA 52722-1644
Phone (563) 742-5150

525 Valley View Dr
Moline, IL 61265-6138
Phone (309) 762-9869

Hospital & facility affiliations

  • Unity Point at Home Home health agency, Moline, IL, CCN 147009
  • Unitypoint Hospice Hospice, Moline, IL, CCN 141583
  • Trinity Rock Island Hospital, Rock Island, IL, CCN 140280
  • Trinity - Bettendorf Hospital, Bettendorf, IA, CCN 160104
  • Trinity Muscatine Hospital, Muscatine, IA, CCN 160013
  • Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.124754ILMDStudent in an Organized Health Care Education/Training Program
125053616ILMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation Family Medicine CurrentSince Sep 1, 2011 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

8101 Birchwood Ct
Unit R
Urbandale, IA 50131
Phone (515) 471-9363

600 N College Ave
Ste 120
Geneseo, IL 61254
Phone (309) 944-5342

3904 16th St
Ste A
Moline, IL 61265
Phone (309) 581-7620

525 Valley View Dr
Moline, IL 61265
Phone (309) 601-2800

Interoperability endpoints

  • Direct secure messaging: nkukhar92321@direct.unitypoint.org

Organizations & group practices 2

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 6

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": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1780868604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 VALLEY VIEW DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656138",
            "telephone_number": "309-762-9869",
            "fax_number": "309-762-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 VALLEY VIEW DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656138",
            "telephone_number": "309-762-9869",
            "fax_number": "309-762-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUKHAR",
        "first_name": "NATALIYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-27",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125053616",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036124754",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "036.124754",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780868604",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01019756",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

Verify at the official NPI Registry.