Individual provider Active NPI

Bernd Michael Kutzscher, M.D.

  • Ophthalmology Physician
  • Daly City, CA
National Provider Identifier
1891791133
Registry record updated Sep 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G53132 Issued in CA
Practice address
1850 Sullivan Ave
Ste 540
Daly City, CA 94015-2215
Phone
(650) 755-6900
Fax
(650) 755-2107
NPI assigned
Jun 22, 2005
Last updated
Sep 24, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G53132 CA Primary

Addresses

Primary practice location

1850 Sullivan Ave
Ste 540
Daly City, CA 94015-2215

Mailing address

1850 Sullivan Ave
Ste 540
Daly City, CA 94015-2215
Phone (650) 755-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040623000892 CA Practitioner - Ophthalmology 7315928843 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G53132CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Eye Specialists, a Professional Corporation Current Accepting new patients
Pacific Eye Specialists, a Professional Corporation Ophthalmology CurrentSince Jan 1, 2004 Accepting new patients
St. Mary's Eye Specialists, PC Ophthalmology PastSince Apr 26, 2004 Accepting new patients

Locations

1850 Sullivan Ave
Ste 540
Daly City, CA 94015
Phone (650) 755-6900

Interoperability endpoints

  • Direct secure messaging: bkutzscher183257@hisp.ehr.sutterhealth.org

Organizations & group practices 3

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1891791133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 SULLIVAN AVE",
            "address_2": "STE 540",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152215",
            "telephone_number": "650-755-6900",
            "fax_number": "650-755-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 SULLIVAN AVE",
            "address_2": "STE 540",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152215",
            "telephone_number": "650-755-6900",
            "fax_number": "650-755-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTZSCHER",
        "first_name": "BERND",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G53132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

Verify at the official NPI Registry.