MICAH LYNN ANN CLUTTER
NPI 1053948521
Physician Assistant in Rockford, IL

Active since March 25, 2020PECOS EnrolledAccepts Medicare Assignment
324 ROXBURY RD, ROCKFORD, IL 61107(815) 398-9491(815) 381-7498 Get Directions Write a Review

NPPES record last updated: July 30, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 30, 2020, Mar 25, 2020 (2 updates tracked since 2020).

About Micah Lynn Ann Clutter NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICAH LYNN ANN CLUTTER (NPI 1053948521) is an individual physician assistant in Rockford, Illinois, licensed in Illinois (085-007766) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS, is affiliated with Waukesha Memorial Hospital, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1053948521
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMICAH LYNN ANN CLUTTER
Location Address324 ROXBURY RDRockford, IL 61107-5090
Mailing AddressBox 78534Milwaukee, WI 53278-8534 · (815) 398-9491 · Fax (815) 381-7498
Fax(815) 381-7498
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMarch 25, 2020
Last NPPES UpdateJuly 30, 20202 updates tracked since enumeration
NPPES CertifiedJuly 30, 2020
NPI 1053948521 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in IL · 085-007766
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedSpecialist/Technologist · Athletic TrainerTaxonomy 2255A2300X
324 ROXBURY RD, Rockford, IL 61107

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Micah Lynn Ann Clutter is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID345665071
PECOS Enrollment IDI20211202002134
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702
This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.
61 services24 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
44 services38 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
24 services24 patients
X-ray of wrist, minimum of 3 views 73110
An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.
20 services15 patients
X-ray of elbow, minimum of 3 views 73080
An elbow X-ray with a minimum of 3 views is a non-invasive imaging test. It helps visualize the bones of the elbow from different angles. This aids in diagnosing conditions like fractures or arthritis. The procedure is quick, painless, and usually takes around 15 minutes.
18 services17 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
13 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Waukesha Memorial Hospital

Acute Care Hospitals · Waukesha, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520008
Location725 American AveWaukesha, WI 53188 · Waukesha County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
324 ROXBURY RD
ROCKFORD, IL 61107
Physician Assistant
324 ROXBURY RD
ROCKFORD, IL 61107
Occupational Therapist
324 ROXBURY RD
ROCKFORD, IL 61107
Physician Assistant
324 ROXBURY RD
ROCKFORD, IL 61107
Physician Assistant
324 ROXBURY RD
ROCKFORD, IL 61107
Physical Therapist
324 ROXBURY RD
ROCKFORD, IL 61107
Physician Assistant (Surgical)
324 ROXBURY RD
ROCKFORD, IL 61107
Physical Medicine & Rehabilitation
324 ROXBURY RD
ROCKFORD, IL 61107

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Micah Clutter's NPI number?

The NPI number for Micah Clutter is 1053948521. It was assigned to this individual provider in the NPPES registry on March 25, 2020.

Where is Micah Clutter located?

Micah Clutter practices at 324 Roxbury Rd, Rockford, IL 61107. The listed phone number is (815) 398-9491.

What is Micah Clutter's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Micah Clutter enrolled in Medicare?

Yes. Micah Clutter is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Micah Clutter accept?

Health plans from Anthem Blue Cross and Blue Shield, Network Health and UnitedHealthcare list Micah Clutter as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Micah Clutter affiliated with any hospitals?

According to CMS data, Micah Clutter is affiliated with Waukesha Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Micah Clutter was last updated on July 30, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.