Individual provider Active NPI

Ruta R. Kulys, LCSW

  • Clinical Social Worker
  • Springfield, IL
National Provider Identifier
1801865282
Registry record updated Nov 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149005034 Issued in IL
Practice address
901 W Jefferson St
Springfield, IL 62702-4833
Phone
(217) 545-8000
Fax
(217) 545-2275
NPI assigned
Mar 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149005034 IL Primary

Addresses

Primary practice location

901 W Jefferson St
Springfield, IL 62702-4833

Mailing address

PO Box 19642
Springfield, IL 62794-9642
Phone (217) 545-8000

Other identifiers 1

IdentifierTypeStateIssuer
222014OtherILTRICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060328000341 IL Practitioner - Clinical Social Worker 6901814268 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Oct 7, 2013 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Oct 7, 2013 Accepting new patients
Board of Trustees of Southern Illinois University Past Accepting new patients

Locations

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

901 W Jefferson St
Springfield, IL 62702
Phone (217) 545-8229

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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Siu Physicians and Surgeons Inc 316 clinicians

Practice addresses (Care Compare)

751 N Rutledge St
Springfield, IL 62702-4968
Phone (217) 545-8000

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384214400000",
    "number": "1801865282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19642",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949642",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W JEFFERSON ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024833",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULYS",
        "first_name": "RUTA",
        "middle_name": "R.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2013-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149005034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "222014",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.