Katie Lynne Sutter, OD

Primary specialty

Pediatric OptometristTaxonomy code 152WP0200X

License

4901004789 Issued in MI

Practice address

6101 Newport Rd Ste a
Portage, MI 49002-9237

Phone

(269) 382-6500

Fax

(269) 382-2286

NPI assigned

Jul 17, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kalamazoo Optometry PCGroup PAC ID 7012819659, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kalamazoo Optometry PC

  • Optometrist
  • Portage, MI
  • NPI 1417148669
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1043651128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 NEWPORT RD STE A",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490029237",
            "telephone_number": "269-382-6500",
            "fax_number": "269-382-2286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 NEWPORT RD STE A",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490029237",
            "telephone_number": "269-382-6500",
            "fax_number": "269-382-2286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTER",
        "first_name": "KATIE",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MI",
            "license": "4901004789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "4901004789",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gail Sulkey
• Erika Lynn Sullenberger
• Mary Sullivan
• Surgery Center of Kalamazoo LLC
• Susan M. Dennis, D.D.S.
• Ronald Swank
• Bethany Swartz, OTRL
• Cameron John Swinehart
• Sherri Lynn Swinehart, MA, LPC, LMSW
• Synergy Neuropsychiatry, PC

• Pediatric Optometrist in Portage, MI
• Providers in Portage, MI by specialty
• Pediatric Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.