Individual provider Active NPI

Michael Lee Kula, PSYD

  • Psychologist
  • Milwaukee, WI
National Provider Identifier
1831251321
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1433 Issued in WI
Practice address
2801 W Kinnickinnic River Pkwy
Ste 347
Milwaukee, WI 53215-3693
Phone
(414) 385-2877
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1433 WI Primary

Addresses

Primary practice location

2801 W Kinnickinnic River Pkwy
Ste 347
Milwaukee, WI 53215-3693

Mailing address

PO Box 510058
New Berlin, WI 53151-0058
Phone (414) 385-2877

Other identifiers 1

IdentifierTypeStateIssuer
39091400MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20040608000219 WI Practitioner - Clinical Psychologist 3779566229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2801 W Kinnickinnic River Pkwy
Suite 365
Milwaukee, WI 53215-3693
Phone (414) 385-2877

PO Box
Suite 510058
New Berlin, WI 53151-0058

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1433WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Michael L Kula Psy D S.C. Psychologist CurrentSince Jan 1, 1995 Accepting new patients
Diagnostic Assessment and Memory Services, LLC Psychologist Past Accepting new patients

Locations

2801 W Kinnickinnic River Pkwy
Ste 347
Milwaukee, WI 53215
Phone (414) 385-2877

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215
Phone (414) 384-5111

2801 W Kinnickinnic River Pkwy
Ste 365
Milwaukee, WI 53215
Phone (414) 385-2877

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.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1831251321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 510058",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531510058",
            "telephone_number": "414-385-2877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY",
            "address_2": "STE 347",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153693",
            "telephone_number": "414-385-2877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULA",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39091400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.