Cory Allen Kutlick, D.O.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

34.010220 Issued in OH

Practice address

1675 E Main St
Box 328
Kent, OH 44240-5818

Phone

(330) 593-1049

Fax

(330) 572-3836

NPI assigned

Jul 11, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Diagnostic Radiology

Education

Lake Erie College of Osteopathic Medicine, Erie, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbus Radiology CorpGroup PAC ID 6507754983, 290 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064
• HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276
• MH St Joseph Warren Hospital Hospital, Warren, OH, CCN 360161
• Mercy Regional Medical Center Hospital, Lorain, OH, CCN 360172
• Southeastern Ohio Regional Medical Center Hospital, Cambridge, OH, CCN 360203

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Columbus Radiology Corp

  • Diagnostic Radiology Physician
  • Columbus, OH
  • NPI 1669408159
  Medicare reassignment Care Compare group
• Scientific Medical Imaging, Inc.

  • Specialist
  • Youngstown, OH
  • NPI 1912900341
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Health Youngstown LLC

  • Clinical Medical Laboratory
  • Warren, OH
  • NPI 1538233309

  Hospital

  Care Compare affiliation
• Mercy Health Youngstown LLC

  • General Acute Care Hospital
  • Youngstown, OH
  • NPI 1548296106
  Care Compare affiliation
• Mercy Health Youngstown LLC

  • General Acute Care Hospital
  • Warren, OH
  • NPI 1629009964
  Care Compare affiliation
• Mercy Health Youngstown LLC

  • General Acute Care Hospital
  • Youngstown, OH
  • NPI 1790868982
  Care Compare affiliation
• Mercy Health Youngstown LLC

  • Clinical Medical Laboratory
  • Youngstown, OH
  • NPI 1831600295

  Hospital

  Care Compare affiliation
• Mercy Health-Regional Medical Center LLC

  • Clinical Medical Laboratory
  • Lorain, OH
  • NPI 1164971800

  Hospital

  Care Compare affiliation
• Mercy Health-Regional Medical Center LLC

  • General Acute Care Hospital
  • Lorain, OH
  • NPI 1245274950
  Care Compare affiliation
• Southeastern Ohio Regional Medical Center Inc

  • Rural Acute Care Hospital
  • Cambridge, OH
  • NPI 1346247350
  Care Compare affiliation

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1336303114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 E MAIN ST",
            "address_2": "BOX 328",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442405818",
            "telephone_number": "330-593-1049",
            "fax_number": "330-572-3836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 E MAIN ST",
            "address_2": "BOX 328",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442405818",
            "telephone_number": "330-593-1049",
            "fax_number": "330-572-3836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTLICK",
        "first_name": "CORY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-11",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "34.010220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0051702",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet Kubera, FNP-BC
• Ashlynn Rae Kufleitner
• Tyler Kuhn, M.A.
• Samuel Kulp, MS, ATC, NREMT
• Lindsay Kutash
• Hope Kvasnicka
• Miranda Sharelle Lackey
• Jerome Lago
• Justin Lajuett
• David D.Y. Lan, M. D.

• Diagnostic Radiology Physician in Kent, OH
• Providers in Kent, OH by specialty
• Diagnostic Radiology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.