Active NPI
Kaylie Machutta, MD
- Surgery Physician
- Portland, ME
National Provider Identifier
1073213401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- EC251007
- Practice address
- 22 Bramhall St
Portland, ME 04102-3175 - Phone
- (207) 662-0111
- NPI assigned
- Mar 6, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Surgery Physician | 208600000X | EC251007 | ME | Primary |
Addresses
Primary practice location
22 Bramhall St
Portland, ME 04102-3175
Mailing address
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-0111
Other practice location 1
1155 Mill St
Reno, NV 89502-1576
Phone (775) 982-4100
Other practice location 2
1100 15th St Apt 150B
Sparks, NV 89431-3657
Phone (775) 722-6583
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240711004444 | CO | Order and Referring Only - General Surgery | 5890230007 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| EC251007 | ME | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750896000000",
"number": "1073213401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 BRAMHALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023134",
"telephone_number": "207-662-0111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 BRAMHALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023175",
"telephone_number": "207-662-0111"
}
],
"practiceLocations": [
{
"address_1": "1155 Mill St",
"address_purpose": "LOCATION",
"city": "Reno",
"state": "NV",
"postal_code": "895021576",
"country_code": "US",
"telephone_number": "775-982-4100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1100 15th St Apt 150B",
"address_purpose": "LOCATION",
"city": "Sparks",
"state": "NV",
"postal_code": "894313657",
"country_code": "US",
"telephone_number": "775-722-6583",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MACHUTTA",
"first_name": "KAYLIE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-06",
"last_updated": "2025-06-26",
"certification_date": "2025-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "ME",
"license": "EC251007",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.