Active NPI
Jeffrey T Kulp, MD
- Geriatric Medicine (Internal Medicine) Physician
- Colorado Springs, CO
National Provider Identifier
1972506053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 30216
- Practice address
- 2350 International Cir
Colorado Springs, CO 80910 - Phone
- (719) 475-5065
- Fax
- (719) 475-5797
- NPI assigned
- May 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 30216 | CO | Primary |
Addresses
Primary practice location
2350 International Cir
Colorado Springs, CO 80910
Mailing address
2350 International Cir
Colorado Springs, CO 80910
Phone (719) 475-5065
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01302165 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070509000579 | CO | Practitioner - Internal Medicine | 6305887506 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Pennsylvania State University College of Medicine, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Agewell Medical Associates PC
Practice addresses (Care Compare)
2350 International Cir
Colorado Springs, CO 80910-3139
Phone (719) 475-5065
Hospital & facility affiliations
- Enhabit Home Health
- Better Healthcare
- Uch-Memorial Health System
- Centura Health-Penrose St Francis Health Services
- Uchealth Grandview Hospital
- Uchealth Pikes Peak Regional Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30216 | CO | MD | Geriatric Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agewell Medical Associates, PC | Current | Accepting new patients | |
| Uch-MHS | Past | Accepting new patients |
Locations
1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120
3225 International Cir
Ste 102
Colorado Springs, CO 80910
Phone (719) 425-5065
325 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 471-6512
2350 International Cir
Colorado Springs, CO 80910
Phone (719) 475-5065
Interoperability endpoints
- jeffkulp@agewellmedicalassociates.ssdirect.aprima.com
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.
-
- Ambulance
- Colorado Springs, CO
- NPI 1417512559
Hospital & facility affiliations 25
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Colorado Springs, CO
- NPI 1457802522
-
- Home Health Agency
- Greenwood Village, CO
- NPI 1851057905
-
- General Acute Care Hospital
- Colorado Springs, CO
- NPI 1801436415
Hospital
-
- General Acute Care Hospital
- Colorado Springs, CO
- NPI 1932112125
Hospital
-
- Home Health Agency
- Colorado Springs, CO
- NPI 1346481710
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335916800000",
"number": "1972506053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2350 INTERNATIONAL CIR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80910",
"telephone_number": "719-475-5065",
"fax_number": "719-475-5797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2350 INTERNATIONAL CIR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80910",
"telephone_number": "719-475-5065",
"fax_number": "719-475-5797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KULP",
"first_name": "JEFFREY",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-23",
"last_updated": "2012-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "CO",
"license": "30216",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01302165",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.