Michelle Kristine Kut, P.A.-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

5601003976 Issued in MI

Practice address

25599 Kelly Rd
Suite a
Roseville, MI 48066-4975

Phone

(586) 772-6000

Fax

(586) 772-7700

NPI assigned

Jan 11, 2007

Sex

Female

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AIIFDD

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.

• Orthopedic Associates of Port Huron PC

  • Durable Medical Equipment & Medical Supplies
  • Port Huron, MI
  • NPI 1013068188
  NPD (past)
• St Clair Cardiovascular Surgeons PLC

  • Cardiovascular Disease Physician
  • Roseville, MI
  • NPI 1194714980
  NPD (past)
• St. Clair Cardiovascular Surgeons, PLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Port Huron, MI
  • NPI 1922275312
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1508916800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25599 KELLY RD",
            "address_2": "SUITE A",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664975",
            "telephone_number": "586-772-6000",
            "fax_number": "586-772-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25599 KELLY RD",
            "address_2": "SUITE A",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664975",
            "telephone_number": "586-772-6000",
            "fax_number": "586-772-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUT",
        "first_name": "MICHELLE",
        "middle_name": "KRISTINE",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601003976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASST LICENSE",
            "identifier": "5601003976",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD7959",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD7957",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dale Joseph Kretunski, P.T.
• Kroger Co of Michigan
• Kroger Co of Michigan
• Kroger Co of Michigan
• Pacharee Kulwattanaporn, D.D.S.
• L&M Transportation ,LLC
• Marna Lacy-Barker
• Carmen A Lafia, MD
• Albert Lavallee, RPH
• Claude Douglas Lees, MD

• Surgical Physician Assistant in Roseville, MI
• Providers in Roseville, MI by specialty
• Surgical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.