| Dr Roger T Kucway, MD | |
|
800 Stewart Rd, Monroe, MI 48162-4226 | |
| (734) 240-1800 | |
| Not Available |
| Full Name | Dr Roger T Kucway |
|---|---|
| Gender | Male |
| Speciality | Radiation Oncology |
| Experience | 28 Years |
| Location | 800 Stewart Rd, Monroe, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417049818 | NPI | - | NPPES |
| P00422855 | Other | OH | RR MEDICARE |
| 5182210 | Medicaid | MI | |
| 0N24000017 | Other | MI | MEDICARE |
| 2361386 | Medicaid | OH | |
| 5201594 | Other | MI | MI MEDICAID- OH LOCATIONS |
| P00639054 | Other | MI | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0001X | Radiology - Radiation Oncology | 35.090157 (Ohio) | Secondary |
| 2085R0001X | Radiology - Radiation Oncology | 4301070053 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Promedica Monroe Regional Hospital | Monroe, MI | Hospital |
| Promedica Toledo Hospital | Toledo, OH | Hospital |
| Emma L Bixby Medical Center | Adrian, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Promedica Multi Specialty Physicians | 7113182809 | 141 |
| Promedica Multi Specialty Physicians | 7113182809 | 141 |
| Entity Name | Promedica Central Physicians |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043270150 PECOS PAC ID: 2365348190 Enrollment ID: O20110310000073 |
| Entity Name | Promedica Monroe Physicians Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194078055 PECOS PAC ID: 2365696176 Enrollment ID: O20130201000483 |
| Entity Name | Promedica Multi Specialty Physicians |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306105150 PECOS PAC ID: 7113182809 Enrollment ID: O20240723002026 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Roger T Kucway, MD 1 Seagate # 800, Toledo, OH 43604-1558 Ph: (734) 240-1800 | Dr Roger T Kucway, MD 800 Stewart Rd, Monroe, MI 48162-4226 Ph: (734) 240-1800 |
Dr. Craig Shepherd Smith, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 718 N. Macomb, Monroe, MI 48161 Phone: 734-240-8400 | |
Dr. Sudjono Kosim, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 718 N. Macomb, Monroe, MI 48161 Phone: 734-240-8400 |