Individual provider Active NPI

Brett Cutler, DPM

  • Podiatrist
  • St Augustine, FL
National Provider Identifier
1710987805
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
P02940 Issued in FL
Practice address
105 Southpark Blvd
Ste A103
St Augustine, FL 32086-4162
Phone
(904) 824-0869
Fax
(904) 826-0966
NPI assigned
Jul 29, 2005
Last updated
Jun 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X P02940 FL Primary

Addresses

Primary practice location

105 Southpark Blvd
Ste A103
St Augustine, FL 32086-4162

Mailing address

105 Southpark Blvd
Ste A103
St Augustine, FL 32086-4162
Phone (904) 824-0869

Other identifiers 3

IdentifierTypeStateIssuer
340202900MedicaidFL
65716OtherFLBCBS
4298427OtherFLAETNA

Other names 1

  • Brett Cutler Professional name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
P02940FLMDPodiatrist
1280TXMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Texas Foot Specialist PA Podiatrist Past Accepting new patients
Brett Cutler DPM PA Podiatrist PastSince Oct 18, 2001 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, 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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1710987805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SOUTHPARK BLVD",
            "address_2": "STE A103",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320864162",
            "telephone_number": "904-824-0869",
            "fax_number": "904-826-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SOUTHPARK BLVD",
            "address_2": "STE A103",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320864162",
            "telephone_number": "904-824-0869",
            "fax_number": "904-826-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUTLER",
        "first_name": "BRETT",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "P02940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340202900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "65716",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4298427",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRETT",
            "last_name": "CUTLER",
            "credential": "DPM PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.