Michael Kutryb, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME0068787 Issued in FL

Practice address

730 S Washington Ave
Titusville, FL 32780

Phone

(210) 267-2020

NPI assigned

Jun 30, 2006

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

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

University of Missouri, Columbia School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michael J Kutryb MD PAGroup PAC ID 7012016579, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parrish Medical Center Hospital, Titusville, FL, CCN 100028

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mkutryb@kutrybeye.eyefinity-direct.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.

• Michael J Kutryb MD PA

  • Ophthalmology Physician
  • Titusville, FL
  • NPI 1902921737

  FL

  Medicare reassignment Care Compare group Authorized official
• Eye Site of Tampa Bay PA

  • Ophthalmology Physician
  • Clearwater, FL
  • NPI 1689773657

  Ophthalmology

  NPD (past)
• Eye Site of Tampa Bay PA

  • Ophthalmology Physician
  • New Port Richey, FL
  • NPI 1750478632

  Ophthalmology

  NPD (past)

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

• North Brevard County Hospital District

  • General Acute Care Hospital
  • Titusville, FL
  • NPI 1053424648

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1649209115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 S WASHINGTON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327804232",
            "telephone_number": "210-267-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 S WASHINGTON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "32780",
            "telephone_number": "210-267-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTRYB",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0068787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6805869003",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "180034420",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0499756",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378367700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "27322",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nikolaos Koukos, ARNP-FNP
• Brooke Erin Kovinsky, DDS
• Lillian Katherine Krick
• Joanielee Kriz, D.C.
• Richard Krubel, MD
• Miranda Jade Lacey, RBT
• Stephen Jonas Lagergren, MD
• Lagoon Dental PLLC
• Michael Laguerre
• Paula Lakeman, D.C

• Ophthalmology Physician in Titusville, FL
• Providers in Titusville, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.