Individual provider Active NPI

Patrick Aaron Kut, M.D.

  • Family Medicine Physician
  • Port Huron, MI
National Provider Identifier
1063496123
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301062024 Issued in MI
Practice address
2603 Electric Ave
Suite 3
Port Huron, MI 48060-6588
Phone
(810) 985-1680
Fax
(810) 985-1518
NPI assigned
Dec 2, 2005
Last updated
Mar 24, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301062024 MI Primary

Addresses

Primary practice location

2603 Electric Ave
Suite 3
Port Huron, MI 48060-6588

Mailing address

PO Box 610669
Port Huron, MI 48061-0669
Phone (810) 985-1884

Other identifiers 1

IdentifierTypeStateIssuer
4492675MedicaidMI

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040128000527 MI Practitioner - Family Practice 4385547355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Port Huron Physicians Medical Group PCGroup PAC ID 0840507802, 9 clinicians

Practice addresses (Care Compare)

2603 Electric Ave
3 Lake Huron Med GRP
Port Huron, MI 48060-6588
Phone (810) 985-1680

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Port Huron Physicians Medical Group PC Family Medicine CurrentSince Sep 1, 2015 Accepting new patients
Aaron K. Clark MD PC Family Medicine PastSince Dec 12, 2007 Accepting new patients

Locations

4190 24th Ave
Ste 208
Fort Gratiot, MI 48059
Phone (810) 216-4000

1985 Gratiot Blvd
Marysville, MI 48040
Phone (734) 451-9692

2603 Electric Ave
Ste 3
Port Huron, MI 48060
Phone (810) 985-1680

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11879/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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

Hospital & facility affiliations 4

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1063496123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 610669",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480610669",
            "telephone_number": "810-985-1884",
            "fax_number": "810-966-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 ELECTRIC AVE",
            "address_2": "SUITE 3",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606588",
            "telephone_number": "810-985-1680",
            "fax_number": "810-985-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUT",
        "first_name": "PATRICK",
        "middle_name": "AARON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301062024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4492675",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.