Shannon P Kukulka, APRN - Medicare Nurse Practitioner in New Haven, CT

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Shannon P Kukulka, APRN is a medicare enrolled "Nurse Practitioner - Gerontology" in New Haven, Connecticut. Her current practice location is 874 Howard Ave, New Haven, Connecticut. You can reach out to her office (for appointments etc.) via phone at (203) 688-8200.

Shannon P Kukulka is licensed to practice in Connecticut (license number 6878) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1982072591.

Contact Information

Shannon P Kukulka, APRN
874 Howard Ave,
New Haven, CT 06519-1106
(203) 688-8200
(203) 688-8200

Map and Direction




Provider's Profile

Full NameShannon P Kukulka
GenderFemale
SpecialityNurse Practitioner - Gerontology
Location874 Howard Ave, New Haven, Connecticut
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1982072591
  • Provider Enumeration Date: 09/14/2015
  • Last Update Date: 01/03/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 8527362045
  • Enrollment ID: I20170124002591

Medical Identifiers

Medical identifiers for Shannon P Kukulka such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1982072591NPI-NPPES
1982072591OtherCTUNITED HEALTHCARE
1982072591OtherCTMULTIPLAN
4869372OtherCTAETNA
1982072591OtherCTANTHEM
1982072591MedicaidCT
AA533003OtherCTHARVARD PILGRIM
P5602305OtherCTOXFORD
6028631OtherCTCIGNA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LG0600XNurse Practitioner - Gerontology 6878 (Connecticut)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shannon P Kukulka allows following entities to bill medicare on her behalf.
Entity NameNortheast Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1043278351
PECOS PAC ID: 1254233836
Enrollment ID: O20040123000522
Entity NameGeriatric And Adult Psychiatry, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770791493
PECOS PAC ID: 4486648946
Enrollment ID: O20040408001301

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shannon P Kukulka is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Shannon P Kukulka, APRN
874 Howard Ave,
New Haven, CT 06519-1106

Ph: (203) 688-8200		Shannon P Kukulka, APRN
874 Howard Ave,
New Haven, CT 06519-1106

Ph: (203) 688-8200

Reviews and Comments


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Alexa Blood, APRN
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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.