Individual provider Active NPI

Katherine Brown Puttgen, M.D.

  • Pediatric Dermatology Physician
  • Baltimore, MD
National Provider Identifier
1275747529
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Dermatology PhysicianTaxonomy code 207NP0225X
License
D0065611 Issued in MD
Practice address
Harriet Lane Childrens Building
200 North Wolfe Street, Lower Level
Baltimore, MD 21287-0001
Phone
(410) 955-2049
Fax
(410) 614-9308
NPI assigned
May 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dermatology Physician 207NP0225X D0065611 MD Primary

Addresses

Primary practice location

Harriet Lane Childrens Building
200 North Wolfe Street, Lower Level
Baltimore, MD 21287-0001

Mailing address

200 N Wolfe St Unit 2107
Pediatric Dermatology, Johns Hopkins Hospital
Baltimore, MD 21287-0011
Phone (443) 615-4653

Other identifiers 1

IdentifierTypeStateIssuer
014070800MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20190131000886 UT Practitioner - DermatologyPractitioner - Pediatric Medicine 3779674643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Emory University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

3723 W 12600
Suite 270
Riverton, UT 84065-7296
Phone (801) 285-4600

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions245
Removal or shaving of skin growth1-10
Skin biopsy67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0065611MDMDPediatric Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Jun 29, 2019 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jun 29, 2019 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

3723 W 12600 S
Ste 270
Riverton, UT 84065
Phone (801) 285-4600

3845 W 4700 S
#2
West Valley City, UT 84129

3845 W 4700 S
West Valley City, UT 84129
Phone (801) 840-2020

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1275747529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N WOLFE ST UNIT 2107",
            "address_2": "PEDIATRIC DERMATOLOGY, JOHNS HOPKINS HOSPITAL",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870011",
            "telephone_number": "443-615-4653",
            "fax_number": "410-614-9308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HARRIET LANE CHILDRENS BUILDING",
            "address_2": "200 NORTH WOLFE STREET, LOWER LEVEL",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870001",
            "telephone_number": "410-955-2049",
            "fax_number": "410-614-9308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTTGEN",
        "first_name": "KATHERINE",
        "middle_name": "BROWN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "MD",
            "license": "D0065611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014070800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.