NPIMap

Individual provider Active NPI

Leila Kutob, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Anderson, SC
National Provider Identifier
1245762871
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
85343 Issued in SC
Practice address
800 N Fant St
Anderson, SC 29621-5708
Phone
(864) 512-1000
NPI assigned
Apr 2, 2017
Last updated
Jul 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 85343 SC Primary

Addresses

Primary practice location

800 N Fant St
Anderson, SC 29621-5708

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

Other identifiers 2

IdentifierTypeStateIssuer
85343OtherSCLICENSE
853437MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20220321002429 SC Practitioner - Pathology 9133514573 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of South Carolina School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Pathology PAGroup PAC ID 4789640673, 13 clinicians
Piedmont Pathology Associates PAGroup PAC ID 8729098959, 5 clinicians

Practice addresses (Care Compare)

316 Calhoun St
Charleston, SC 29401-1113
Phone (843) 724-2260

800 N Fant St
Anderson, SC 29621-5708
Phone (864) 226-1558

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90 of 100Reported as group
Quality
80
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85343SCMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Pathology, P.a. Anatomic Pathology & Clinical Pathology CurrentSince May 22, 2025 Accepting new patients
Diagnostic Radiology of Anderson, P.a. Current Accepting new patients
Charleston Pathology PA Anatomic Pathology & Clinical Pathology Current Accepting new patients
Charleston Pathology PA Anatomic Pathology & Clinical Pathology CurrentSince May 22, 2025 Accepting new patients
Piedmont Pathology Associates PA Anatomic Pathology & Clinical Pathology CurrentSince Dec 11, 2021 Accepting new patients
Charleston Pathology PA Anatomic Pathology & Clinical Pathology Current Accepting new patients
Morgan County Georgia Hospital Authority Current Accepting new patients
Charleston Pathology PA Anatomic Pathology & Clinical Pathology Current Accepting new patients

Locations

5700 Southwyck Blvd
Toledo, OH 43614

800 N Fant St
Anderson, SC 29621
Phone (864) 512-1000

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200

Interoperability endpoints

  • Direct secure messaging: leilakutob@mmc.medalliesdirect.net

Organizations & group practices 8

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 6

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": "1491091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1245762871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215708",
            "telephone_number": "864-512-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTOB",
        "first_name": "LEILA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-02",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SC",
            "license": "85343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "85343",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "853437",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.