ANDREA S KULDANEK (NPI# 1093720815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093720815 |
| Entity Type | Individual |
| Full Name | ANDREA S KULDANEK |
| Credential | MD |
| Practice Address |
3350 Eagle Park Dr Ne Suite 108 Grand Rapids MI 49525-4570 |
| Practice Telephone | 6164581088 |
| Practice Fax Number | 6164587809 |
| Mailing Telephone | 6164581088 |
| Mailing Fax Number | 6164587809 |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2012-12-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P0010X |
Physical Medicine & Rehabilitation Specialization: Pediatric Rehabilitation Medicine |
AK041190 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MEDICARE RR | RR250010074 | 01 |
| MI | 1403831 | 05 |
| Street Address |
3350 EAGLE PARK DR NE SUITE 108 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49525-4570 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548379571 | Rehabilitation Medicine Associates,plc | Physical Medicine & Rehabilitation | 3350 Eagle Park Dr Ne, Suite 108, Grand Rapids, MI 49525-4570 | 2006-08-30 |
| 1366455677 | Brian P Giersch | Physical Medicine & Rehabilitation | 3350 Eagle Park Dr Ne, Suite 108, Grand Rapids, MI 49525-4570 | 2006-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928507 | Therapy With Nicole Pllc | Community/Behavioral Health | 4867 E. Beltline Ave. Ne, Building #1 Lower Level, Grand Rapids, MI 49525 | 2020-09-29 |
| 1184242760 | Christian Healthcare Specialists, Inc. | Obstetrics & Gynecology | 3322 Beltline Court Ne, Suite 1, Grand Rapids, MI 49525 | 2020-07-09 |
| 1174154645 | Amy Vanderslik | Case Manager/Care Coordinator | 3310 Eaglecrest Park Dr. Ne, Suite 100, Grand Rapids, MI 49525 | 2020-02-03 |
| 1477195246 | Epic Discoveries LLC | Counselor | 4867 E. Beltline Ave Ne, Grand Rapids, MI 49525 | 2019-10-14 |
| 1598228959 | Kim Scherencel Lmsw Counseling | Social Worker | 3280 Beltline Ne, Grand Rapids, MI 49525 | 2019-04-11 |
| 1821558958 | Mindful Trajectories | Social Worker | 3280 Beltlne Ct Ne, Grand Rapids, MI 49525 | 2019-03-24 |
| 1104380518 | Julianne Lettinga, Ma Lpc Counseling | Counselor | 3280 East Beltline Ct Ne, Grand Rapids, MI 49525 | 2019-01-30 |
| 1396227229 | Christopher Scot Doucette | Social Worker | 2064 Airway St Ne, Grand Rapids, MI 49525 | 2018-09-06 |
| 1568976017 | Amy K. Deyoung, Dds, Ms, PC Pediatric Dentistry | Dentist | 3297 Eagle Run Dr. Ne, Grand Rapids, MI 49525 | 2017-11-20 |
| 1407389604 | Kelly Jo Crabb | Social Worker | 4829 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49525 | 2017-04-05 |
| Find all providers in zip 49525 | ||||
| Taxonomy Code | 2081P0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pediatric Rehabilitation Medicine |
| A physiatrist who utilizes an interdisciplinary approach and addresses the prevention, diagnosis, treatment and management of congenital and childhood-onset physical impairments including related or secondary medical, physical, functional, psychosocial and vocational limitations or conditions, with an understanding of the life course of disability. This physician is trained in the identification of functional capabilities and selection of the best of rehabilitation intervention strategies, with an understanding of the continuum of care. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate for PRM was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Early discussions underway |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194886887 | Neal M. Alpiner, M.d., Pllc | Physical Medicine & Rehabilitation | 40800 Woodward Ave, Bloomfield Hills, MI 48304-5060 | 2006-12-13 |
| 1356823058 | Wendy Lee Nichollls | Physical Medicine & Rehabilitation | 4949 Coolidge Hwy, Royal Oak, MI 48073-1026 | 2018-08-30 |
| 1821194317 | Kenneth E Fox | Physical Medicine & Rehabilitation | 5500 Armstrong Rd, Battle Creek, MI 49037-7314 | 2006-09-15 |
| 1730116682 | Eileen Marie Donovan | Physical Medicine & Rehabilitation | 18501 Rotunda Dr Ste 200, Dearborn, MI 48124-3891 | 2006-06-27 |
| City | GRAND RAPIDS |
| Zip Code | 49525 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.