Individual provider Active NPI

Thomas Kutner

  • Internal Medicine Physician
  • Media, PA
National Provider Identifier
1730641119
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD486179 Issued in PA
Practice address
1088 W Baltimore Pike Ste 2500
Media, PA 19063-5166
Phone
(484) 227-8800
NPI assigned
Apr 3, 2019
Last updated
May 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD486179 PA Primary
Cardiovascular Disease Physician 207RC0000X MD486179 PA

Addresses

Primary practice location

1088 W Baltimore Pike Ste 2500
Media, PA 19063-5166

Mailing address

3803 W Chester Pike Ste 160
Newtown Square, PA 19073-2336

Other practice location 1

22 S Greene St Rm N3E09
Baltimore, MD 21201-1544
Phone (410) 328-6110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250509001699 PA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 6709118920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Jefferson Medical College of Thomas Jefferson University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

1088 W Baltimore Pike
Suite 2500
Media, PA 19063-5166
Phone (610) 565-4107

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD486179PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Internal Medicine CurrentSince Jul 1, 2025 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

1088 W Baltimore Pike
Ste 2500
Media, PA 19063
Phone (610) 565-2449

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1730641119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088 W BALTIMORE PIKE STE 2500",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635166",
            "telephone_number": "484-227-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 S Greene St Rm N3E09",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011544",
            "country_code": "US",
            "telephone_number": "410-328-6110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUTNER",
        "first_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD486179",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD486179",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.