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KEVIN PULLUKAT MD
NPI 1992552772
Student in an Organized Health Care Education/Training Program in Detroit, MI

Active since May 01, 2024PECOS Enrolled
3901 BEAUBIEN ST, DETROIT, MI 48201(313) 745-1892 Get Directions Write a Review

NPPES record last updated: May 1, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kevin Pullukat Md NPPES

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

KEVIN PULLUKAT MD (NPI 1992552772) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since May 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1992552772
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameKEVIN PULLUKATCredential: MD
Location Address3901 BEAUBIEN STDetroit, MI 48201-2119
Mailing Address49718 Waterstone Estates CirNorthville, MI 48168-4900
Phone(313) 745-1892
Sole ProprietorNo
Enumeration DateMay 1, 2024
NPPES CertifiedMay 1, 2024
✔ NPI 1992552772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
3901 BEAUBIEN ST, Detroit, MI 48201
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kevin Pullukat Md 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.

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.

KAROLINA MAKSIMOWSKI
Pediatrics (Pediatric Emergency Medicine)
3901 BEAUBIEN ST
DETROIT, MI 48201
Wayne County (313) 745-5260
NUTRENA TATE CNP
Nurse Practitioner (Pediatrics)
3901 BEAUBIEN ST
DETROIT, MI 48201
Wayne County (313) 745-5437
DR. RUPA THACKER M.D
Pediatrics
3901 BEAUBIEN ST
DETROIT, MI 48201
Wayne County (313) 745-5533
SYBRENA EVANS
Physician Assistant (Surgical)
3901 BEAUBIEN ST
DETROIT, MI 48201
Wayne County (313) 833-4490
JOSHUA KIM DO
Pediatrics
3901 BEAUBIEN ST
DETROIT, MI 48201
Wayne County (313) 745-5870
HANNAH L MORELLO MSN, RN
Nurse Practitioner (Pediatrics)
3901 BEAUBIEN ST
DETROIT, MI 48201
Wayne County (543) 731-3745
ERIC MARC ESHMAN PHARM.D.
Pharmacist
3901 BEAUBIEN ST
DETROIT, MI 48201
Wayne County (313) 966-0414
KELLY HOLZHAUSEN
Pharmacist
3901 BEAUBIEN ST
DETROIT, MI 48201
Wayne County (734) 552-5323

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 Pullukat's NPI number?

The NPI number for Kevin Pullukat is 1992552772. It was assigned to this individual provider in the NPPES registry on May 1, 2024.

Where is Kevin Pullukat located?

Kevin Pullukat practices at 3901 Beaubien St, Detroit, MI 48201. The listed phone number is (313) 745-1892.

What is Kevin Pullukat's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kevin Pullukat enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Kevin Pullukat was last updated on May 1, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.