Issa H Kutkut, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

01087821A Issued in IN

Practice address

800 Broadway Ste 200
Fort Wayne, IN 46802-2149

Phone

(260) 458-3410

Fax

(260) 425-2881

NPI assigned

Jun 18, 2015

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Interventional Cardiology

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017
• Dupont Hospital LLC Hospital, Fort Wayne, IN, CCN 150150
• Kosciusko Community Hospital Hospital, Warsaw, IN, CCN 150133
• St Joseph Health System, LLC Hospital, Fort Wayne, IN, CCN 150047
• The Orthopaedic Hospital of Lutheran Health Networ Hospital, Ft Wayne, IN, CCN 150168

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: issa.kutkut@lutheranhealthnetwork.cernerdirect.com

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.

• Lutheran Medical Group LLC

  • Cardiovascular Disease Physician
  • Fort Wayne, IN
  • NPI 1164662805

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Lutheran Medical Group LLC

  • Durable Medical Equipment & Medical Supplies
  • Fort Wayne, IN
  • NPI 1710275664
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dupont Hospital LLC

  dba Dupont Hospital

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1538110556
  Care Compare affiliation
• Iom Health System LP

  dba Lutheran Hospital of Indiana

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1306897335
  Care Compare affiliation
• Lutheran Musculoskeletal Center LLC

  dba The Orthopaedic Hospital of Lutheran Health Network

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1174706576
  Care Compare affiliation
• St. Joseph Health System, LLC

  dba Lutheran Downtown Hospital

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1023060472
  Care Compare affiliation
• Warsaw Health System LLC

  dba Lutheran Kosciusko Hospital

  • General Acute Care Hospital
  • Warsaw, IN
  • NPI 1164475711
  Care Compare affiliation

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1528449220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY",
            "address_2": "SUITE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3514",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BROADWAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468022149",
            "telephone_number": "260-458-3410",
            "fax_number": "260-425-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTKUT",
        "first_name": "ISSA",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-18",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01087821A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "issa.kutkut@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "800 Broadway Ste 200",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468022149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Venkata L Kureti, MD
• Kurt H. Gregory D.B.a. Family Support Services of Northen Indiana
• David Lee Kurtz, MSW, LSW
• Michael Thomas Kurtz, ATC
• Stacey Kurut
• Mary Ena Kuyvenhoven
• Victor Kuzma, DO
• Il-Sung Kwak, M.D.
• Matthew Alan Kwiatkowski
• Emily Kyburz, RDN, CD

• Cardiovascular Disease Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Cardiovascular Disease Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.