Individual provider Active NPI

Morris Kutner, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Lakeland, FL
National Provider Identifier
1457416554
Registry record updated May 4, 2017
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128b(4) exclusion effective Nov 20, 2023.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
ME005867 Issued in FL
Practice address
3058 Highlands by the Lake Way
#6
Lakeland, FL 33812-5044
Phone
(863) 687-1321
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X ME005867 FL Primary

Addresses

Primary practice location

3058 Highlands by the Lake Way
#6
Lakeland, FL 33812-5044

Mailing address

102 S Evers St
Suite 104
Plant City, FL 33563-5403
Phone (813) 754-7756

Other identifiers 5

IdentifierTypeStateIssuer
12375OtherFLBCBS
0405441OtherFLEVERCARE
054685200MedicaidFL
423475OtherAETNA
380001598OtherFLMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME005867FLMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osteopathic Medical Arts Center of South Florida LLC Past Accepting new patients
Juan O Bravo MD PL Past Accepting new patients

Organizations & group practices 2

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1457416554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 S EVERS ST",
            "address_2": "SUITE 104",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335635403",
            "telephone_number": "813-754-7756",
            "fax_number": "813-754-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3058 HIGHLANDS BY THE LAKE WAY",
            "address_2": "#6",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338125044",
            "telephone_number": "863-687-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTNER",
        "first_name": "MORRIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME005867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "12375",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "0405441",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054685200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "423475",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "380001598",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.