Kenneth A. Krutt, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

55836 Issued in MA

Practice address

37 Broadway
37 Broadway
Arlington, MA 02474-5552

Phone

(781) 641-0100

Fax

(781) 744-7132

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

No

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 MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Lahey Clinic, Inc

  • Internal Medicine Physician
  • Peabody, MA
  • NPI 1063447316

  Internal Medicine, MA

  Medicare reassignment NPD

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1356433288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 BROADWAY",
            "address_2": "LAHEY ARLINGTON",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024745552",
            "telephone_number": "781-641-0100",
            "fax_number": "781-744-7132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 BROADWAY",
            "address_2": "37 BROADWAY",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024745552",
            "telephone_number": "781-641-0100",
            "fax_number": "781-744-7132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUTT",
        "first_name": "KENNETH",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "55836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110044053A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Alan Koenig, MA
• Kaitlen Korney
• Jeltje A Koumans, M.D.
• Kevork Kouyoumjian, PHARM D
• Whitney Kraemer, LMHC
• Emily Kuhl, LMHC
• Jennifer White Kuliesis, MSW, LICSW
• Robert Nicholas Kum, D.C.
• Lisa Kunins, MD
• Jayme Kurland, LCSW

• All providers in Arlington, MA
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; 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.

Verify at the official NPI Registry.