NPIMap

Individual provider Active NPI

Danielle Nicole Kutzenberger, P.A.

  • Surgical Physician Assistant
  • College Station, TX
National Provider Identifier
1407184724
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA06547 Issued in TX
Practice address
2803 Earl Rudder Fwy S Ste 103
College Station, TX 77845-6099
Phone
(979) 731-8888
Fax
(979) 731-8935
NPI assigned
Nov 24, 2009
Last updated
Apr 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA06547 TX Primary

Addresses

Primary practice location

2803 Earl Rudder Fwy S Ste 103
College Station, TX 77845-6099

Mailing address

2800 S Texas Ave Ste 202
Bryan, TX 77802-5361
Phone (979) 774-2053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100202000176 TX Practitioner - Physician Assistant 4385787159 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Regional Health CenterGroup PAC ID 5294727921, 141 clinicians

Practice addresses (Care Compare)

2801 Franciscan Dr
Bryan, TX 77802-2544
Phone (979) 776-2401

2803 Earl Rudder Fwy S
College Station, TX 77845-6099
Phone (979) 731-8888

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc CurrentSince Aug 25, 2014 Accepting new patients
St Joseph Emergency Physicians PLLC CurrentSince Feb 22, 2012 Accepting new patients
St. Joseph Regional Health Center CurrentSince Jan 29, 2018 Accepting new patients
St Joseph Regional Health Center CurrentSince Jan 29, 2018 Accepting new patients
TMH Physician Associates PLLC Past Accepting new patients
Traditions Emergency Medicine PA Past Accepting new patients
College Station Hospital LP Past Accepting new patients

Locations

2800 S Texas Ave
Ste 202
Bryan, TX 77802
Phone (979) 774-2060

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

2803 Earl Rudder Fwy S
Ste 103
College Station, TX 77845
Phone (979) 731-8888

3526 Longmire Dr
Ste 200
College Station, TX 77845
Phone (979) 696-3344

1401 St Joseph Pkwy
Houston, TX 77002
Phone (713) 575-1000

Interoperability endpoints

  • Direct secure messaging: danielle.kutzenberger@sjrhc.eclinicaldirectplus.com
  • Direct secure messaging: dkutzenberger457290@direct.stlukeshealth.org

Organizations & group practices 10

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 2

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": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1407184724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 S TEXAS AVE STE 202",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025361",
            "telephone_number": "979-774-2053",
            "fax_number": "979-776-5914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2803 EARL RUDDER FWY S STE 103",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456099",
            "telephone_number": "979-731-8888",
            "fax_number": "979-731-8935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTZENBERGER",
        "first_name": "DANIELLE",
        "middle_name": "NICOLE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-24",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA06547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.