Michelle R Kroupa-Kulik, MD
Individual provider Active NPI Pediatrics Physician · Munising, MI
NPI 1891743480 · NPPES record last updated Jan 23, 2013
Key facts
- NPI
- 1891743480
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 4301068824 (MI)
- Practice address
- 1500 Sandpoint Rd
Munising, MI 49862-1406 - Phone
- (906) 387-4338
- Fax
- (906) 387-2825
- NPI assigned
- May 5, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- Michigan State University College of Human Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sault Tribe of Chippewa Indians
Practice addresses (Care Compare)
2864 Ashmun St
Sault S Marie, MI 49783-3740
Phone (906) 632-5200
Hospital & facility affiliations
- Uphs Marquette DLP Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101109001077 | MI | Practitioner - Pediatric Medicine | 4183819717 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sault Tribe of Chippewa Indians | Current | Accepting new patients | |
| Sault Tribe of Chippewa Indians | Current | Accepting new patients | |
| Sault Tribe of Chippewa Indians | Current | Accepting new patients |
Locations
2864 Ashmun St
Sault South Marie, MI 49783
Phone (906) 632-5200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301068824 | MI | |
| Pediatrics Physician | 208000000X | 4301068824 | MI | Yes |
Addresses
Primary practice location
1500 Sandpoint Rd
Munising, MI 49862-1406
Mailing address
1500 Sandpoint Rd
Munising, MI 49862-1406
Phone (906) 387-4338
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 774301871 | Medicaid | MI | |
| 23-8650 | Other | MI | RHC CERTIFICATION NUMBER (CMS) |
| 080A760010 | Other | MI | BCBS |
Other providers in Munising, MI
- Kareem Said MD
- Bonnie Lou Kilpela
- Joshua David Kocha
- Dylan Koenig
- Derek Lowell Kolbus
- Christine M Krueger
- Cheri Lare
- Zachary Thomas Leveque
- M K Stores Inc
- Cordelia Miller
All providers in Munising, MI · Pediatrics Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.