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DR. KEVIN KUKOLECK PSYD
NPI 1295821171
Psychologist - Clinical in Travis Afb, CA

Active since October 05, 2006PECOS Enrolled
101 BODIN CIR, TRAVIS AFB, CA 94535(707) 423-5174 Get Directions Write a Review

NPPES record last updated: September 25, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 25, 2024, Sep 23, 2021, Aug 2, 2019 (3 updates tracked since 2019).

About Dr. Kevin Kukoleck Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KEVIN KUKOLECK PSYD (NPI 1295821171) is an individual clinical provider in Travis Afb, California, licensed in California (29905) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1295821171
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameDR. KEVIN KUKOLECKCredential: PSYD
Location Address101 BODIN CIRTravis Afb, CA 94535-1809
Mailing Address101 Bodin CirTravis Afb, CA 94535-1809 · (707) 423-5174
Phone(707) 423-5174
Sole ProprietorYes
Enumeration DateOctober 5, 2006
Last NPPES UpdateSeptember 25, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 25, 2024
✔ NPI 1295821171 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Licenses✔ Licensed in CA · 29905✔ Licensed in OH · 08214
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
101 BODIN CIR, Travis Afb, CA 94535
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kevin Kukoleck Psyd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Kevin Kukoleck reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Department Of State Hospitals
17 mi
Psychiatric Hospital
2100 NAPA VALLEJO HWY
Napa, CA 94558
  • Reassigned Medicare billing, California enrollment
  • 755 clinicians in this Medicare group
NPI 1326098161 (707) 253-5000
Grow Healthcare Group PC
65 mi
Mental Health
99 S ALMADEN BLVD STE 600
San Jose, CA 95113
  • Reassigned Medicare billing, California enrollment
  • 3,139 clinicians in this Medicare group
NPI 1154994846 (408) 402-4385
Psychology Consultants Inc
2,129 mi
Clinical
3591 RESERVE COMMONS DR, SUITE 301
Medina, OH 44256
  • Reassigned Medicare billing, Ohio enrollment
  • 28 clinicians in this Medicare group
NPI 1205882941 (330) 764-7916
Grow Healthcare Group PA
2,573 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, Illinois and Ohio enrollments
  • 581 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94535 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$191.95 typical visit price
range $65.02 – $191.95
Typical copayment $47.98 (range $16.25 – $47.98)
Most-billed visit code 99205
Established Patient
$113.05 typical visit price
range $21.86 – $157.69
Typical copayment $28.26 (range $5.46 – $39.42)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EDWARD SEAN RODRIGUEZ I.D.M.T
Military Health Care Provider (Independent Duty Medical Technicians)
101 BODIN CIR
TRAVIS AFB, CA 94535
Solano County (707) 423-5478
KENDRA MONICA HILL PT
Physical Therapist
101 BODIN CIR
TRAVIS AFB, CA 94535
Solano County (707) 423-3000
TIMOTHY GUENTHER MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
101 BODIN CIR
TRAVIS AFB, CA 94535
Solano County (707) 423-3000
ANGELA SABRINA GIESE MD
Surgery (Vascular Surgery)
101 BODIN CIR
FAIRFIELD, CA 94535
Solano County (707) 423-3000
DR. JOSCELYN D. A. C. AQUININGOC PHARMD
Pharmacist
101 BODIN CIR
TRAVIS AFB, CA 94535
Solano County (626) 297-8649
MATTHEW NICHOLAS RIBEIRO MD
Anesthesiology
101 BODIN CIR
FAIRFIELD, CA 94535
Solano County (707) 423-3000
DR. ARTHUR JOSEPH MESTAS MD
Family Medicine
101 BODIN CIR
TRAVIS AFB, CA 94535
Solano County (707) 423-7295
CATHERINE CELINE BRANSTETTER
Dentist (General Practice)
101 BODIN CIR
TRAVIS AFB, CA 94535
Solano County (707) 423-7085

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Kukoleck's NPI number?

The NPI number for Kevin Kukoleck is 1295821171. It was assigned to this individual provider in the NPPES registry on October 5, 2006.

Where is Kevin Kukoleck located?

Kevin Kukoleck practices at 101 Bodin Cir, Travis Afb, CA 94535. The listed phone number is (707) 423-5174.

What is Kevin Kukoleck's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Kevin Kukoleck enrolled in Medicare?

Yes. Kevin Kukoleck is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kevin Kukoleck's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Kukoleck reassigns Medicare benefits to 4 organizations: Department Of State Hospitals (Napa, CA), Grow Healthcare Group PC (San Jose, CA), Psychology Consultants Inc (Medina, OH) and Grow Healthcare Group PA (Miami, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kevin Kukoleck's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kevin Kukoleck accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource, MedMutual and UnitedHealthcare list Kevin Kukoleck as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kevin Kukoleck was last updated on September 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.