Active NPI
Morris Kutner, M.D.
- Geriatric Medicine (Internal Medicine) Physician
- Lakeland, FL
National Provider Identifier
1457416554
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.
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- ME005867
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12375 | Other | FL | BCBS |
| 0405441 | Other | FL | EVERCARE |
| 054685200 | Medicaid | FL | |
| 423475 | Other | AETNA | |
| 380001598 | Other | FL | MEDICARE 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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME005867 | FL | MD | Geriatric Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
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- Coral Springs, FL
- NPI 1336258243
-
- Family Medicine Physician
- Hollywood, FL
- NPI 1316412836
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.