Individual provider Active NPI

Michael A Kutmas, D.O.

  • Emergency Medicine Physician
  • Joplin, MO
National Provider Identifier
1699717678
Registry record updated Apr 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
R8E70 Issued in MO
Practice address
100 Mercy Way
Joplin, MO 64804-4524
Phone
(417) 556-2300
Fax
(417) 556-3625
NPI assigned
Jun 12, 2006
Last updated
Apr 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R8E70 MO Primary
Family Medicine Physician 207Q00000X R8E70 MO

Addresses

Primary practice location

100 Mercy Way
Joplin, MO 64804-4524

Mailing address

3125 Dr Russell Smith Way
Carthage, MO 64836-7402
Phone (417) 455-0395

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20041209000000 MO Practitioner - Emergency MedicinePractitioner - Family Practice 7517923774 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R8E70MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Aurora CurrentSince Sep 20, 2014 Accepting new patients
Mercy Hospital Aurora CurrentSince Sep 20, 2014 Accepting new patients
Potosi Emergency Group, LLC Emergency Medicine CurrentSince Apr 16, 2017 Accepting new patients
Sjmgroup Past Accepting new patients
Carthage Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

500 Porter Ave
Aurora, MO 65605
Phone (417) 678-2122

300 Health Way Dr
Potosi, MO 63664
Phone (573) 438-2977

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1699717678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 DR RUSSELL SMITH WAY",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648367402",
            "telephone_number": "417-455-0395",
            "fax_number": "417-455-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MERCY WAY",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044524",
            "telephone_number": "417-556-2300",
            "fax_number": "417-556-3625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTMAS",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "R8E70",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R8E70",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.