Victoria Kustarz, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

12231 Issued in FL

Practice address

544 NW University Blvd Ste 103
Port St Lucie, FL 34986-2283

Phone

(772) 763-1311

NPI assigned

Jul 10, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Awaken Chiropractic Center IncGroup PAC ID 7517391865, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Awaken Chiropractic Center Inc

  • Chiropractor
  • Port St Lucie, FL
  • NPI 1174167613
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1801318076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 NW UNIVERSITY BLVD STE 103",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862283",
            "telephone_number": "772-763-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 NW UNIVERSITY BLVD STE 103",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862283",
            "telephone_number": "772-763-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSTARZ",
        "first_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "12231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam D Kurtin, D.O.
• Brian Marti Kusel, D.D.S.
• Conrad James Kusel Jr., D.D.S.
• Bruce A Kushner, D.M.D.
• Robert Matthew Kustarz, MS DC
• Kymbella Healthcare
• Kymbella Wellness Center & Exotics
• Lab Stop USA, Inc
• Kenneth Francis Labarge III, DC
• Gusti Labatte-Deneau, ARNP

• Chiropractor in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.