NPIMap

Individual provider Active NPI

Nuhad Afif Kulaylat, M.D.

  • Nephrology Physician
  • Drexel Hill, PA
National Provider Identifier
1841240421
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
2002006960 Issued in MO
Practice address
1012 Shadeland Ave
Drexel Hill, PA 19026-1913
Phone
(573) 334-9564
Fax
(573) 334-1879
NPI assigned
May 12, 2006
Last updated
Apr 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X E-3226 AR
Nephrology Physician 207RN0300X 036-107478 IL
Nephrology Physician 207RN0300X 2002006960 MO Primary

Addresses

Primary practice location

1012 Shadeland Ave
Drexel Hill, PA 19026-1913

Mailing address

1349 N Mount Auburn Rd
Cape Girardeau, MO 63701-1727
Phone (573) 334-9564

Other identifiers 9

IdentifierTypeStateIssuer
481120OtherMOHEALTHLINK
5M291OtherARBLUE CROSS BLUE SHIELD
110237678OtherRAIL ROAD MEDICARE
096560OtherHEALTH ALLIANCE
205990708MedicaidMO
158646OtherMOBLUE CROSS BLUE SHIELD
205990716MedicaidMO
148096001MedicaidAR
2104551OtherCOVENTRY HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190807000055 PA Practitioner - HospitalistPractitioner - Internal Medicine 9638211287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 371-2200

1086 Franklin St
Johnstown, PA 15905-4305
Phone (814) 534-5585

763 Johnsonburg Rd
Saint Marys, PA 15857-3417
Phone (814) 788-8000

809 Turnpike Ave
Clearfield, PA 16830-1232
Phone (814) 765-5341

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.42 of 100Reported as group
Quality
75.58
Improvement activities
40
Cost
72.74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-107478ILMDNephrology Physician
2002006960MOMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group of Pennsylvania PC CurrentSince Jul 1, 2019 Accepting new patients
Apogee Medical Group of Pennsylvania PC CurrentSince Jul 1, 2019 Accepting new patients
Dubois Regional Medical Center Past Accepting new patients
Dubois Regional Medical Center Past Accepting new patients
Brookville Hospital Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

100 Hospital Rd
Brookville, PA 15825
Phone (814) 849-1408

809 Turnpike Ave
Clearfield, PA 16830
Phone (814) 765-5341

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

Organizations & group practices 6

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.

Hospital & facility affiliations 36

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1841240421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1349 N MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637011727",
            "telephone_number": "573-334-9564",
            "fax_number": "573-334-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 SHADELAND AVE",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190261913",
            "telephone_number": "573-334-9564",
            "fax_number": "573-334-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULAYLAT",
        "first_name": "NUHAD",
        "middle_name": "AFIF",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AR",
            "license": "E-3226",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036-107478",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MO",
            "license": "2002006960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "481120",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5M291",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "110237678",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "096560",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205990708",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "158646",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205990716",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148096001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTHCARE",
            "identifier": "2104551",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Drexel Hill, PA

Sources for this page

Verify at the official NPI Registry.