Organization Active NPI

Karen R Kutikoff MD PA

  • Internal Medicine Physician
  • Loxahatchee, FL
National Provider Identifier
1972662229
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
KAREN R KUTIKOFF MD PA
Practice address
12957 Palms West Dr
BLDG 9 Suite 101
Loxahatchee, FL 33470-4989
Phone
(561) 790-3750
Fax
(561) 792-5874
NPI assigned
Dec 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Karen R Kutikoff, MDNPI 1710997994
Title
President
Phone
(561) 790-3750

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

12957 Palms West Dr
BLDG 9 Suite 101
Loxahatchee, FL 33470-4989

Mailing address

12957 Palms West Dr
BLDG 9 Suite 101
Loxahatchee, FL 33470-4989
Phone (561) 790-3750

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070102000357 FL Part B Supplier - Clinic/Group Practice 9638179302 Receives reassigned benefits from 1 practitioner
Practice locations: Loxahatchee, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0992278Karen Kutikoff MD PA12957 Palms West Dr Ste 201 BLDG 9, Loxahatchee, FL 33470Certificate of waiverOct 10, 2027

National Provider Directory

National Provider Directory

Locations

12957 Palms West Dr
Ste 201
Loxahatchee, FL 33470
Phone (561) 429-8238

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972662229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12957 PALMS WEST DR",
            "address_2": "BLDG 9 SUITE 101",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334704989",
            "telephone_number": "561-790-3750",
            "fax_number": "561-792-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12957 PALMS WEST DR",
            "address_2": "BLDG 9 SUITE 101",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334704989",
            "telephone_number": "561-790-3750",
            "fax_number": "561-792-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAREN R KUTIKOFF MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KUTIKOFF",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-790-3750",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loxahatchee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.