Robert B Kanuckel, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50000110 Issued in OH

Practice address

7709 Hoke Rd
Englewood, OH 45315-9725

Phone

(937) 836-4000

Fax

(937) 540-1090

NPI assigned

May 12, 2006

Last updated

Apr 29, 2019By 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 OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urgent Care Specialists, LLCGroup PAC ID 1850311010, 81 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Urgent Care Specialists, LLC

  dba Hometown Urgent Care

  • Urgent Care Clinic/Center
  • Huber Heights, OH
  • NPI 1114957123
  Medicare reassignment Care Compare group
• Hometown Urgent Care of Michigan, P.C.

  dba Hometown Urgent Care

  • Urgent Care Clinic/Center
  • Huber Heights, OH
  • NPI 1790030385
  Medicare reassignment NPD
• Fairfield Hospitalists Inc

  • Internal Medicine Physician
  • Fairfield, OH
  • NPI 1508900226
  NPD (past)
• Middletown Emergency Physicians, Inc.

  • Emergency Medicine Physician
  • Franklin, OH
  • NPI 1932108784
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1821049198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164",
            "telephone_number": "800-875-0136",
            "fax_number": "937-619-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7709 HOKE RD",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453159725",
            "telephone_number": "937-836-4000",
            "fax_number": "937-540-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANUCKEL",
        "first_name": "ROBERT",
        "middle_name": "B",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50000110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE FAIFIELD",
            "identifier": "P00150614",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Shanae Jones, LPN
• Robert Gary Jones III
• Kristin L Jumer, LPCC
• Just4You LLC
• Elizabeth Ann Kahlig, OD
• Tiffany Ann Karas, PA-C
• Kare Solutions LLC
• Hannah Elizabeth Karimian-Dominique, PT, DPT
• Karl G. Espeleta, DDS, LLC
• Karrington of Englewood LTD (Sunrise of Englewood)

• Physician Assistant in Englewood, OH
• Providers in Englewood, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; 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.