Individual provider Active NPI

Charles Kutler, MD

  • Infectious Disease Physician
  • Kingston, NY
National Provider Identifier
1063464519
Registry record updated Mar 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
211804 Issued in NY
Practice address
360 Washington Avr
Kingston, NY 12401-5144
Phone
(845) 338-7140
Fax
(845) 338-7141
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 53630 KY
Infectious Disease Physician 207RI0200X 211804 NY Primary

Addresses

Primary practice location

360 Washington Avr
Kingston, NY 12401-5144

Mailing address

360 Washington Ave
Kingston, NY 12401-3702
Phone (845) 338-7140

Other identifiers 1

IdentifierTypeStateIssuer
02361677MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040719001297 NY Practitioner - Infectious DiseasePractitioner - Internal Medicine 8224017561 Reassigns benefits to 2 organizations
I20190716000271 WI Practitioner - Infectious Disease 8224017561

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

600 Westage Business Ctr D
Fishkill, NY 12524-2281
Phone (845) 231-5600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Nov 29, 2021 Accepting new patients
Optum Medical Care, P.C. CurrentSince Nov 29, 2021 Accepting new patients
Medical Associates of the Hudson Valley Infectious Disease CurrentSince Jul 1, 2005 Accepting new patients
Ector County Hospital District Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

600 Westage Business Ctr Dr
#D
Fishkill, NY 12524

360 Washington Ave
Kingston, NY 12401
Phone (845) 338-7140

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

30 Columbia St
Poughkeepsie, NY 12601
Phone (845) 483-5934

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: ckutler142235@direct.optum.com
  • Direct secure messaging: ckutler@direct.health-quest.org

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1063464519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 WASHINGTON AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013702",
            "telephone_number": "845-338-7140",
            "fax_number": "845-338-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 WASHINGTON AVR",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015144",
            "telephone_number": "845-338-7140",
            "fax_number": "845-338-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTLER",
        "first_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "KY",
            "license": "53630",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "211804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02361677",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.