Mary K Kukolich, MD is a medicare enrolled "Medical Genetics - Clinical Genetics (m.d.)" physician in Fort Worth, Texas. She went to Js Weill Medical College, Cornell University and graduated in 1971 and has 54 years of diverse experience with area of expertise as Pediatric Medicine. She is a member of the group practice Cook Childrens Physician Network and her current practice location is
750 8th Ave Ste 200, Fort Worth, Texas. You can reach out to her office (for appointments etc.) via phone at
(682) 885-2170.
Mary K Kukolich is licensed to practice in Texas (license number E5817) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1912918111.
Physician's Profile
| Full Name | Mary K Kukolich |
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| Gender | Female |
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| Speciality | Pediatric Medicine |
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| Experience | 54 Years |
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| Location | 750 8th Ave Ste 200, Fort Worth, Texas |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mary K Kukolich attended and graduated from Js Weill Medical College, Cornell University in 1971
NPI Data:
- NPI Number: 1912918111
- Provider Enumeration Date: 08/11/2006
- Last Update Date: 05/17/2021
Medicare PECOS Information:
- PECOS PAC ID: 2062408453
- Enrollment ID: I20040421001600
Medical Identifiers
Medical identifiers for Mary K Kukolich such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1912918111 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208000000X | Pediatrics | E5817 (Texas) | Secondary |
| 207SG0201X | Medical Genetics - Clinical Genetics (m.d.) | E5817 (Texas) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Cook Childrens Physician Network | 7719884584 | 149 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mary K Kukolich allows following entities to bill medicare on her behalf.
| Entity Name | Cook Childrens Physician Network |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750369203
PECOS PAC ID: 7719884584
Enrollment ID: O20040128000800 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mary K Kukolich is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mary K Kukolich, MD
Po Box 733784,
Dallas, TX 75373-3784
Ph: (682) 885-1855 | Mary K Kukolich, MD
750 8th Ave Ste 200,
Fort Worth, TX 76104-2500
Ph: (682) 885-2170 |
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