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MARY K KUKOLICH MD
NPI 1912918111
Medical Genetics - Clinical Genetics (M.D.) in Fort Worth, TX

Active since August 11, 2006PECOS EnrolledAccepts Medicare Assignment
750 8TH AVE STE 200, FORT WORTH, TX 76104(682) 885-2170(817) 335-8277 Get Directions Write a Review

NPPES record last updated: May 17, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 17, 2021, Apr 9, 2021 (2 updates tracked since 2021).

About Mary K Kukolich Md NPPES

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

MARY K KUKOLICH MD (NPI 1912918111) is an individual clinical genetics (m.d.) provider in Fort Worth, Texas, licensed in Texas (E5817) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS and is a graduate of Js Weill Medical College, Cornell University (1971).

NPPES Registry Identity

NPI1912918111
Entity TypeIndividualFemale
Primary Taxonomy207SG0201X
Provider Legal NameMARY K KUKOLICHCredential: MD
Location Address750 8TH AVE STE 200Fort Worth, TX 76104-2500
Mailing AddressPo Box 733784Dallas, TX 75373-3784 · (682) 885-1855 · Fax (682) 885-1396
Phone(682) 885-2170
Fax(817) 335-8277
Sole ProprietorNo
Medical School CMSJs Weill Medical College, Cornell UniversityGraduated 1971
Enumeration DateAugust 11, 2006
Last NPPES UpdateMay 17, 20212 updates tracked since enumeration
NPPES CertifiedMay 17, 2021
✔ NPI 1912918111 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMedical Genetics · Clinical Genetics (M.D.)Allopathic & Osteopathic Physicians
Taxonomy Code207SG0201X
License✔ Licensed in TX · E5817
Definition
A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders.
Also ListedPediatricsTaxonomy 208000000X · License E5817 (TX)
750 8TH AVE STE 200, Fort Worth, TX 76104
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Baylor Scott and White Health Plan, Imperial Insurance Companies, Inc..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

Mary K Kukolich Md 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 ID2062408453
PECOS Enrollment IDI20040421001600
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.

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.

REBECCA KNOCKEMUS RDLD
Dietitian, Registered
750 8TH AVE STE 200
FORT WORTH, TX 76104
Tarrant County (682) 885-2170
ALEXA SHARON BARBAGALLO
Genetic Counselor, MS
750 8TH AVE STE 200
FORT WORTH, TX 76104
Tarrant County (682) 303-4102
DR. JOANNE NGUYEN M.D.
Medical Genetics (Clinical Genetics (M.D.))
750 8TH AVE STE 200
FORT WORTH, TX 76104
Tarrant County (682) 885-2170
LORI LEANN LLERA CPNP
Nurse Practitioner (Pediatrics)
750 8TH AVE STE 200
FORT WORTH, TX 76104
Tarrant County (682) 885-2170
MS. ALICIA DANIELLE HERNANDEZ MS, CGC
Genetic Counselor, MS
750 8TH AVE STE 200
FORT WORTH, TX 76104
Tarrant County (682) 885-5942
TINA GRACE BARBARO DIEBER MD
Medical Genetics (Clinical Genetics (M.D.))
750 8TH AVE STE 200
FORT WORTH, TX 76104
Tarrant County (682) 885-2170
MRS. AMY CHRISTINE THOMAS M.S., C.G.C.
Genetic Counselor, MS
750 8TH AVE STE 200
FORT WORTH, TX 76104
Tarrant County (682) 885-2170
DR. ALEXANDRA GARZA FLORES M.D.
Medical Genetics (Clinical Genetics (M.D.))
750 8TH AVE STE 200
FORT WORTH, TX 76104
Tarrant County (682) 885-2170

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 Mary Kukolich's NPI number?

The NPI number for Mary Kukolich is 1912918111. It was assigned to this individual provider in the NPPES registry on August 11, 2006.

Where is Mary Kukolich located?

Mary Kukolich practices at 750 8th Ave Ste 200, Fort Worth, TX 76104. The listed phone number is (682) 885-2170.

What is Mary Kukolich's specialty?

The primary specialty registered for this NPI is Medical Genetics, specializing in Clinical Genetics (M.D.), with taxonomy code 207SG0201X.

Is Mary Kukolich enrolled in Medicare?

Yes. Mary Kukolich 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 Mary Kukolich accept?

Health plans from Baylor Scott and White Health Plan and Imperial Insurance Companies, Inc. list Mary Kukolich 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 Mary Kukolich was last updated on May 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.