FREDRIC C. KULLBERG (M.D.) – Pulmonary Disease Physician, NPI 1912010273

FREDRIC C. KULLBERG (M.D.) is a healthcare provider. based in Rockford, Illinois. specializing in Pulmonary Disease Physician. They hold the professional credentials M.D.. They hold a License No. 036 062004 (IL). The NPI Number for FREDRIC C. KULLBERG (M.D.) is 1912010273

Main info

Male
50 Years Of Experience
Accepts Medicare Assignment
Name
FREDRIC C. KULLBERG (M.D.)
NPI
1912010273
Phone
(815) 397-7212
Address
535 ROXBURY RD
Enumeration Date
17 August 2006
Last Update Date
4 May 2016

Doctor Profile

Medical School Name
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Secondary Phone
8153871717
Graduation Year
1976 (50 years ago)
PAC ID
4486753373
Group Practice PAC ID
3678889789
Professional Enrollment ID
I20070618000326
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for FREDRIC C. KULLBERG (M.D.)

  • 535, Roxbury Road, Rockford, Winnebago County, Illinois, 61107, United States

    SUITE B600

    ROCKFORD, IL 611075076

    Phone: (815) 397-7212

    Fax: (815) 397-2539

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-06-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070618000326IPulmonary DiseaseILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61107)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3678889789View full group profile

Reviews

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Frequently asked questions

What identifier follows FREDRIC C. KULLBERG (M.D.) across health systems?
The NPI 1912010273 uniquely identifies FREDRIC C. KULLBERG (M.D.) in U.S. healthcare data.
Is FREDRIC C. KULLBERG (M.D.)'s NPI status active today?
Active status means FREDRIC C. KULLBERG (M.D.)'s NPI record is not deactivated in the public file.
Which specialty label fits FREDRIC C. KULLBERG (M.D.)?
NPPES ties FREDRIC C. KULLBERG (M.D.) to Pulmonary Disease Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to FREDRIC C. KULLBERG (M.D.)?
FREDRIC C. KULLBERG (M.D.) is associated with Rockford, Illinois in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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