MICAH LYNN ANN CLUTTER – Physician Assistant, NPI 1053948521
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for MICAH LYNN ANN CLUTTER
BOX 78534
MILWAUKEE, WI 532788534
Phone: (815) 398-9491
Fax: (815) 381-7498
Type: Mailing
324 ROXBURY RD
ROCKFORD, IL 611075090
Phone: (815) 398-9491
Fax: (815) 381-7498
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $13.
Total Amount is formed as General ($13) + Research ($0) + Ownership ($0) = $13.
Last reported payment date: 2023-01-11 • Largest payer in this snapshot: KCI USA, Inc. ($13).
Total Amount
$13
General + Research + Ownership
Payments
1
Total payment records
General Amount
$13
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-01-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| KCI USA, Inc. | $13 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-12-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20211202002134 | I | Physician Assistant | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | 31 | 19 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 24 | 24 | $0 |
| 20550 | Injection into tendon or ligament | 17 | 14 | $0 |
| 73140 | X-ray of finger, minimum of 2 views | 13 | 11 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 53278)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | IL | |
| Orthopedic Surgery | WI | |
| Occupational Therapist In Private Practice | IL | |
| Physical Therapist In Private Practice | IL | |
| Occupational Therapist In Private Practice | OR | |
| Physical Therapist In Private Practice | WI | |
| Orthopedic Surgery | WI | |
| Physical Therapist In Private Practice | IL | |
| Physical Therapist In Private Practice | WI | |
| Orthopedic Surgery | WI |
Reviews
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