NPIMap

Individual provider Active NPI

Richard M Kaut, MD

  • Emergency Medicine Physician
  • Acoma, NM
National Provider Identifier
1114937786
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD15373 Issued in ME
Practice address
80 B Veterans Blvd
Acoma, NM 87034
Phone
(505) 552-5300
Fax
(505) 552-5490
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A49176 CA
Emergency Medicine Physician 207P00000X MD15373 ME Primary

Addresses

Primary practice location

80 B Veterans Blvd
Acoma, NM 87034

Mailing address

PO Box 130
San Fidel, NM 87049-0130
Phone (505) 552-5300

Other identifiers 2

IdentifierTypeStateIssuer
H3451MedicaidNM
00A491760MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040213000213 CA Practitioner - Family Practice 7214821727 Reassigns benefits to 7 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinic Services of California Medical Group Inc Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Chavez Emergency Physicians Medical Group, Inc. Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients
Southland Emergency Medical Associates Inc Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients
Seneca Healthcare District Current Accepting new patients
Glenn Medical Center, LLC Current Accepting new patients
Glenn Medical Center, LLC CurrentSince Jun 5, 2017 Accepting new patients
Team Physicians of California Medical Group Inc Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Orchard Hospital CurrentSince Jul 12, 2014 Accepting new patients
Orchard Hospital CurrentSince Jul 12, 2014 Accepting new patients
Glenn Medical Center, LLC CurrentSince Jun 5, 2017 Accepting new patients
Sierra Rural Physicians, Inc. Emergency Medicine Past Accepting new patients
Regional Radiological Associates, Inc. a Medical Group Past Accepting new patients
Kayenta Alternative Rural Hospital Past Accepting new patients
Central California Radiology Associates Inc Past Accepting new patients

Locations

240 Spruce St
Gridley, CA 95948
Phone (530) 846-5671

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1235 W Vine St
Ste 20
Lodi, CA 95240
Phone (209) 339-7600

1065 Bucks Lake Rd
Quincy, CA 95971
Phone (530) 283-2121

525 W Acacia St
Stockton, CA 95203
Phone (209) 944-5410

869 N Cherry St
Tulare, CA 93274
Phone (559) 326-2800

16850 Bear Valley Rd
Victorville, CA 92395
Phone (760) 241-8222

1133 W Sycamore St
Willows, CA 95988
Phone (530) 934-1800

Interoperability endpoints

  • Direct secure messaging: richard.kaut@3856.securemail.prognocis.com

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1114937786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "SAN FIDEL",
            "state": "NM",
            "postal_code": "870490130",
            "telephone_number": "505-552-5300",
            "fax_number": "505-552-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 B VETERANS BLVD",
            "city": "ACOMA",
            "state": "NM",
            "postal_code": "87034",
            "telephone_number": "505-552-5300",
            "fax_number": "505-552-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUT",
        "first_name": "RICHARD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A49176",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ME",
            "license": "MD15373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H3451",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A491760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Acoma, NM

Sources for this page

Verify at the official NPI Registry.