MEDICARE: DONALD I KUZYK DPM INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	E3256	CA
2	213ES0131X	Foot Surgery Podiatrist	E3256	CA
3	213ER0200X	Radiology Podiatrist	E3256	CA
4	213EP1101X	Primary Podiatric Medicine Podiatrist	E3256	CA
5	213ES0000X	Sports Medicine Podiatrist	E3256	CA
6	213EP0504X	Public Medicine Podiatrist	E3256	CA
7	213E00000X	Podiatrist	E3256	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4522680001	OTHER	CA	DMERC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477638468
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONALD I KUZYK DPM INC

Provider Business Mailing Address
First Line	:	7937 LILY TROTTER ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-2408
Country	:	US
Telephone Number	:	805-732-6310
Fax Number	:

Provider Business Practice Location Address
First Line	:	7937 LILY TROTTER ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-2408
Country	:	US
Telephone Number	:	805-732-6310
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	DONALD I KUZYK
Credential	:
Telephone Number	:	805-732-6310

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	01/16/2026

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