NPIMap

Individual provider Active NPI

Walter Dean Kucaba, DO

  • Family Medicine Physician
  • Duncan, SC
National Provider Identifier
1881787802
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0608 Issued in SC
Practice address
1575 E Main St
Duncan, SC 29334-9218
Phone
(864) 560-3500
Fax
(864) 560-3522
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0608 SC Primary

Addresses

Primary practice location

1575 E Main St
Duncan, SC 29334-9218

Mailing address

PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304

Other practice location 1

8311 Warren H Abernathy Hwy
Spartanburg, SC 29301-1249
Phone (864) 562-5100

Other identifiers 3

IdentifierTypeStateIssuer
216950OtherSCMEDCOST
7132885OtherSCAETNA
006086MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wkucaba41129@direct-srhs.et0939.epichosted.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20070418000219 SC Practitioner - Family Practice 7810092988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

1575 E Main St
Duncan, SC 29334-9218
Phone (864) 560-3500

Hospital & facility affiliations

  • Spartanburg Regional Home Health Home health agency, Spartanburg, SC, CCN 427024
  • Spartanburg Medical Center Hospital, Spartanburg, SC, CCN 420007
  • Pelham Medical Center Hospital, Greer, SC, CCN 420103

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0608SCMDFamily Medicine Physician
608SCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center CurrentSince Oct 23, 2006 Accepting new patients
Spartanburg Medical Center Family Medicine CurrentSince Oct 23, 2006 Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Locations

1575 E Main St
Duncan, SC 29334
Phone (864) 487-3338

101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554

8311 Warren H Abernathy Hwy
Spartanburg, SC 29301
Phone (864) 562-5100

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

2660 Reidville Rd
Unit 1
Spartanburg, SC 29301
Phone (864) 560-9696

1200 E Main St
Ste 12
Spartanburg, SC 29307
Phone (864) 560-9260

Interoperability endpoints

  • Direct secure messaging: wkucaba41129@direct-srhs.et0939.epichosted.com

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1881787802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 E MAIN ST",
            "city": "DUNCAN",
            "state": "SC",
            "postal_code": "293349218",
            "telephone_number": "864-560-3500",
            "fax_number": "864-560-3522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8311 Warren H Abernathy Hwy",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293011249",
            "country_code": "US",
            "telephone_number": "864-562-5100",
            "fax_number": "864-562-5230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUCABA",
        "first_name": "WALTER",
        "middle_name": "DEAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "0608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "216950",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7132885",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006086",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wkucaba41129@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "wkucaba41129@direct-srhs.et0939.epichosted.com",
            "address_1": "1575 E Main St",
            "city": "Duncan",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293349218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duncan, SC

Sources for this page

Verify at the official NPI Registry.