NPIMap

Individual provider Active NPI

Nathan Robert Kukowski, MD

  • Orthopaedic Surgery Physician
  • Augusta, GA
National Provider Identifier
1952899619
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
99362 Issued in GA
Practice address
3650 J Dewey Gray Cir
Augusta, GA 30909-1867
Phone
(706) 863-9797
Fax
(706) 860-7686
NPI assigned
Apr 28, 2018
Last updated
Sep 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Orthopaedic Surgery Physician 207X00000X 99362 GA Primary
Orthopaedic Surgery of the Spine Physician 207XS0117X 99362 GA

Addresses

Primary practice location

3650 J Dewey Gray Cir
Augusta, GA 30909-1867

Mailing address

3650 J Dewey Gray Cir
Augusta, GA 30909-1867
Phone (068) 639-7977

Other practice location 1

57 Executive Park S Rm 160-4
Atlanta, GA 30329-2288
Phone (404) 778-1567

Other practice location 2

55 Fruit St
Boston, MA 02114-2621
Phone (617) 724-8636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240702001588 GA Practitioner - Orthopedic Surgery 2769732783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Texas Southwestern Medical School at Dallas, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1321 Interstate Pkwy
Augusta, GA 30909-5626
Phone (706) 945-0810

3650 J Dewey Gray Cir
Augusta, GA 30909-1867
Phone (706) 863-9797

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion54
Laminectomy or laminotomy (partial removal of spine bones)18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
99362GAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Jul 28, 2023 Accepting new patients
Brigham & Womens Physicians Organization Inc Orthopaedic Surgery CurrentSince Jul 28, 2023 Accepting new patients
Augusta Orthopedic & Sports Medicine Specialists PC Orthopaedic Surgery CurrentSince Jun 11, 2024 Accepting new patients
Massachusetts General Physicians Organization Inc Orthopaedic Surgery CurrentSince Jul 28, 2023 Accepting new patients
Augusta Orthopedic & Sports Medicine Specialists PC Orthopaedic Surgery CurrentSince Jun 11, 2024 Accepting new patients

Locations

3650 J Dewey Gray Cir
Augusta, GA 30909
Phone (706) 863-9797

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

75 Francis St
Boston, MA 02115

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23890/brand/1/csg/1/fhir/r4
  • Direct secure messaging: nathan.kukowski.1@23890.direct.athenahealth.com

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 5

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": "1524873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1952899619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 J DEWEY GRAY CIR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091867",
            "telephone_number": "068-639-7977",
            "fax_number": "706-860-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 J DEWEY GRAY CIR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091867",
            "telephone_number": "706-863-9797",
            "fax_number": "706-860-7686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57 Executive Park S Rm 160-4",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303292288",
            "country_code": "US",
            "telephone_number": "404-778-1567",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "617-724-8636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUKOWSKI",
        "first_name": "NATHAN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-28",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "99362",
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "GA",
            "license": "99362",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.