Active NPI
Kathryn C. Krulisky, MBBS
- Neurology Physician
- Salt Lake City, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 12762265-1205
- Practice address
- 175 North Medical Drive East
Salt Lake City, UT 84132-0001 - Phone
- (801) 382-7007
- NPI assigned
- May 8, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | R76678 | AZ | |
| Clinical Neurophysiology Physician | 2084N0600X | 12762265-1205 | UT | |
| Neurology Physician | 2084N0400X | 12762265-1205 | UT | Primary |
Addresses
Primary practice location
175 North Medical Drive East
Salt Lake City, UT 84132-0001
Mailing address
175 North Medical Drive East
Salt Lake City, UT 84132-0001
Phone (801) 382-7007
Other practice location 1
1501 N Campbell Ave Rm 6204A
Tucson, AZ 85724-0001
Phone (520) 626-3894
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | KKRULISKY580264@DIRECT.MED.UTAH.EDU | Direct | University of Utah |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT, ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 581-4314
Hospital & facility affiliations
- University of Utah Hospital and Clinics
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.77 of 100
- Quality
- 91.47
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.42
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R76678 | AZ | MD | Neurology Physician |
| 12762265-1205 | UT | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pocatello Health Services, LLC | Current | Accepting new patients | |
| Pocatello Health Services, LLC | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| Pocatello Health Services, LLC | Current | Accepting new patients | |
| Bronson Lakeview Hospital | Past | Accepting new patients | |
| Colorado West Healthcare System | Past | Accepting new patients |
Locations
777 Hospital Way
Pocatello, ID 83201
Phone (208) 239-1000
777 Hospital Way
Ste 202
Pocatello, ID 83201
Phone (208) 239-2640
127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478
175 N Medical Dr
Slc, UT 84112
Phone (801) 581-6908
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
Organizations & group practices 8
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.
-
- General Practice Physician
- Salt Lake City, UT
- NPI 1114321981
-
- General Acute Care Hospital
- Pocatello, ID
- NPI 1689802852
-
- Diagnostic Radiology Physician
- Salt Lake City, UT
- NPI 1598169419
-
- Hematology (Internal Medicine) Physician
- Salt Lake City, UT
- NPI 1740684513
-
- Durable Medical Equipment & Medical Supplies
- Pocatello, ID
- NPI 1154089126
-
- General Acute Care Hospital
- Pocatello, ID
- NPI 1215165485
-
- Internal Medicine Physician
- Paw Paw, MI
- NPI 1235131137
-
- General Acute Care Hospital
- Grand Junction, CO
- NPI 1497723407
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1487734976
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1588656870
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1699889576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654041600000",
"number": "1992294607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 NORTH MEDICAL DRIVE EAST",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841320001",
"telephone_number": "801-382-7007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 NORTH MEDICAL DRIVE EAST",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841320001",
"telephone_number": "801-382-7007"
}
],
"practiceLocations": [
{
"address_1": "1501 N Campbell Ave Rm 6204A",
"address_purpose": "LOCATION",
"city": "Tucson",
"state": "AZ",
"postal_code": "857240001",
"country_code": "US",
"telephone_number": "520-626-3894",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KRULISKY",
"first_name": "KATHRYN",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "MBBS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-08",
"last_updated": "2022-06-01",
"certification_date": "2022-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "AZ",
"license": "R76678",
"primary": false
},
{
"code": "2084N0600X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Clinical Neurophysiology",
"state": "UT",
"license": "12762265-1205",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "UT",
"license": "12762265-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "KKRULISKY580264@DIRECT.MED.UTAH.EDU",
"affiliation": "Y",
"affiliationName": "University of Utah",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.