JOHN KUCKELMAN
NPI 1669882304
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Joint Base Lewis Mcchord, WA

Active since May 03, 2014PECOS EnrolledAccepts Medicare Assignment
9040 JACKSON AVE, JOINT BASE LEWIS MCCHORD, WA 98431(253) 968-1110 Get Directions Write a Review

NPPES record last updated: May 17, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 17, 2024, May 9, 2024, Aug 5, 2022 (3 updates tracked since 2022).

About John Kuckelman NPPES

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

JOHN KUCKELMAN (NPI 1669882304) is an individual thoracic surgery (cardiothoracic vascular surgery) provider in Joint Base Lewis Mcchord, Washington, licensed in Washington (DO.OP.61502437-IMLC) and active in the NPI registry since May 2014. He is enrolled in Medicare PECOS, is affiliated with Providence Centralia Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1669882304
Entity TypeIndividualMale
Primary Taxonomy208G00000X
Provider Legal NameJOHN KUCKELMAN
Location Address9040 JACKSON AVEJoint Base Lewis Mcchord, WA 98431-1000
Mailing Address9040 Jackson AveTacoma, WA 98431-0001 · (253) 968-1110 · Fax (253) 968-3219
Sole ProprietorNo
Medical School CMSDes Moines University Of Osteopathic Medicine And Health SciencesGraduated 2014
Enumeration DateMay 3, 2014
Last NPPES UpdateMay 17, 20243 updates tracked since enumeration
NPPES CertifiedMay 10, 2024
NPI 1669882304 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians
Taxonomy Code208G00000X
Licenses Licensed in WA · DO.OP.61502437-IMLC Licensed in GA · 92772
Definition

A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.

9040 JACKSON AVE, Joint Base Lewis Mcchord, WA 98431

Secondary Practice Locations 2

Location 11120 15th StAugusta, GA 30912-1000 · Phone (706) 721-8623 · Fax (706) 721-1459
Location 29040 Fitzsimmons DrJoint Base Lewis McChord, WA 98431-1000 · Phone (253) 968-0236

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

John Kuckelman is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID941516066
PECOS Enrollment IDI20241003001938
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.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Providence Centralia Hospital

Acute Care Hospitals · Centralia, WA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number500019
Location914 S Scheuber RoadCentralia, WA 98531 · Lewis County
Emergency services Birthing friendly

Providence St Peter Hospital

Acute Care Hospitals · Olympia, WA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number500024
Location413 Lilly Road NEOlympia, WA 98506 · Thurston County
Emergency services Birthing friendly

St Joseph Medical Center

Acute Care Hospitals · Tacoma, WA
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number500108
Location1717 South J StreetTacoma, WA 98405 · Pierce County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98431 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
$172.80 typical visit price
range $57.27 – $172.80
Typical copayment $43.20 (range $14.31 – $43.20)
Most-billed visit code 99205
Established Patient
$71.29 typical visit price
range $18.56 – $141.11
Typical copayment $17.82 (range $4.64 – $35.27)
Most-billed visit code 99213
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.

Nurse Practitioner (Family)
9040 JACKSON AVE
TACOMA, WA 98431
Physician Assistant
9040 JACKSON AVE, MAMC FAMILY MED DEPT
TACOMA, WA 98431
Nurse Practitioner (Family)
9040 JACKSON AVE
TACOMA, WA 98431
Nurse Practitioner (Neonatal)
9040 JACKSON AVE
TACOMA, WA 98431
Nurse Practitioner (Adult Health)
9040 JACKSON AVE, MADIGAN ARMY MEDICAL CENTER WTB CLINIC
TACOMA, WA 98431
Registered Nurse (Psychiatric/Mental Health, Adult)
9040 JACKSON AVE, MCHJ-CLQ-C
TACOMA, WA 98431
Counselor (Mental Health)
9040 JACKSON AVE
TACOMA, WA 98431
Specialist
9040 JACKSON AVE
TACOMA, WA 98431

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 John Kuckelman's NPI number?

The NPI number for John Kuckelman is 1669882304. It was assigned to this individual provider in the NPPES registry on May 3, 2014.

Where is John Kuckelman located?

John Kuckelman practices at 9040 Jackson Ave, Joint Base Lewis Mcchord, WA 98431. The listed phone number is (253) 968-1110.

What is John Kuckelman's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Is John Kuckelman enrolled in Medicare?

Yes. John Kuckelman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does John Kuckelman accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list John Kuckelman 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.

Is John Kuckelman affiliated with any hospitals?

According to CMS data, John Kuckelman is affiliated with Providence Centralia Hospital, Providence St Peter Hospital and St Joseph Medical Center.

When was this NPI record last updated?

The NPPES record for John Kuckelman was last updated on May 17, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.