ANDREA S KULDANEK (MD) – Pediatric Rehabilitation Medicine Physician, NPI 1093720815
Pediatric Rehabilitation Medicine Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,204 PEDIATRIC MEDICINE in MI
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Provider Addresses for ANDREA S KULDANEK (MD)
3350, Eagle Park Drive Northeast, Eaglecrest Office Park, Grand Rapids Charter Township, Kent County, Michigan, 49525, United States
SUITE 108
GRAND RAPIDS, MI 495254570
Phone: (616) 458-1088
Fax: (616) 458-7809
Type: Location
235 WEALTHY ST SE
GRAND RAPIDS, MI 495035247
Phone: (616) 840-8005
Fax: (616) 840-9642
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 15 Open Payments records for all available years, with a total value of $313.
Total Amount is formed as General ($313) + Research ($0) + Ownership ($0) = $313.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: ABBVIE INC. ($236).
Total Amount
$313
General + Research + Ownership
Payments
15
Total payment records
General Amount
$313
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $236 |
| Merz Pharmaceuticals, LLC | $56 |
| PIRAMAL CRITICAL CARE | $21 |
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: 2005-07-19
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050719000304 | I | Pediatric Medicine | MI | TBD |
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.
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 49525)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | MI | |
| Physical Therapist In Private Practice | OK | |
| Physical Medicine And Rehabilitation | MI | |
| Physical Medicine And Rehabilitation | MI | |
| Physical Therapist In Private Practice | MI | |
| Physical Medicine And Rehabilitation | MI | |
| - | MI | |
| Physical Medicine And Rehabilitation | MI | |
| Physical Therapist In Private Practice | MI | |
| - | MI |
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