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

NPI Status: Active since March 25, 2020

Contact Information

324 ROXBURY RD
ROCKFORD, IL
ZIP 61107
Phone: (815) 398-9491
Fax: (815) 381-7498

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  • Individual
  • Female
  • Years of Experience 6
  • Physician Assistant
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MICAH CLUTTER

This page provides the complete NPI Profile along with additional information for Micah Clutter, a primary care provider established in Rockford, Illinois with a medical specialization in Physician Assistant and more than 6 years of experience. The healthcare provider is registered in the NPI registry with number 1053948521 assigned on March 2020. The practitioner's primary taxonomy code is 363A00000X with license number 085-007766 (IL). The provider is registered as an individual and her NPI record was last updated 5 years ago.

NPI
1053948521
Provider Name
MICAH LYNN ANN CLUTTER
Gender
Female
Entity Type
Individual
Location Address
324 ROXBURY RD ROCKFORD, IL 61107
Location Phone
(815) 398-9491
Location Fax
(815) 381-7498
Mailing Address
BOX 78534 MILWAUKEE, WI 53278
Mailing Phone
(815) 398-9491
Mailing Fax
(815) 381-7498
Medical School Name
OTHER
Graduation Year
2020
Is Sole Proprietor?
No
Enumeration Date
03-25-2020
Last Update Date
07-30-2020
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A primary care provider (PCP) like Micah Clutter sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
085-007766
License State
IL
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
12255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Specialist/Technologist
Athletic Trainer

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
  • Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
  • Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
  • Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
  • Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
  • Anthem Heart Healthy Bronze Priority/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
  • Anthem Silver Pathway/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Pathway/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Dean Bronze $0 Copay PCP Visits - HMO
  • Dean Bronze Share - HMO
  • Dean Catastrophic - HMO
  • Dean Expanded Bronze Standard - HMO
  • Dean Gold HSA - HMO
  • Dean Gold Share - HMO
  • Dean Gold Standard - HMO
  • Dean Silver $0 Copay PCP Visits - HMO
  • Dean Silver Share - HMO
  • Dean Silver Standard - HMO
  • Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
  • Prestige Bronze Plus - HMO
  • Prestige Gold - HMO
  • Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
  • Prestige Gold Essential + Dental + Vision + 3 Free PCP Visits - HMO
  • Prestige Silver - HMO
  • Prestige Silver Essential + Dental + Vision + 3 Free PCP Visits - HMO
  • Signature Prestige Bronze $0 Deductible + Dental + Vision - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Bronze Value HSA (No Referrals) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Standard (No Referrals) - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Silver Standard (No Referrals) - HMO
  • UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Micah Clutter is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Micah Clutter is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 345665071

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20211202002134

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 19 times for 17 patients

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg

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.

This service was performed 26 times for 14 patients

New patient office or other outpatient visit, 30-44 minutes

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.

This service was performed 12 times for 12 patients

X-ray of wrist, minimum of 3 views

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.

This service was performed 12 times for 11 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $21.42 for a new patient copayment and $17.16 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 61107 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $85.71
  • Minimum New Patient Price $54.8
  • Maximum New Patient Price $168.44
  • Average New Patient Copayment $21.42
  • Minimum New Patient Copayment $13.7
  • Maximum New Patient Copayment $42.11

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $68.64
  • Minimum Established Patient Price $17.16
  • Maximum Established Patient Price $136.56
  • Average Established Patient Copayment $17.16
  • Minimum Established Patient Copayment $4.29
  • Maximum Established Patient Copayment $34.14

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Micah Clutter is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
WAUKESHA MEMORIAL HOSPITAL725 AMERICAN AVE
WAUKESHA, WI 53188
(262) 928-1000Acute Care Hospitals

Reviews for MICAH LYNN ANN CLUTTER

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1053948521
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
201031841654
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 1 + 0 + 3 + 1 + 8 + 4 + 1 + 6 + 5 + 4 + 24 = 59
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 59 = 11

The NPI number 1053948521 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1841303377 NORMAN A HAGMAN M.D.
Individual
Orthopaedic Surgery324 ROXBURY RD
ROCKFORD, IL 61107
(815) 398-9491
1750497905 CAROL BITNER P.T.
Individual
Physical Therapist324 ROXBURY RD
ROCKFORD, IL 61107
(815) 398-9491
1316053291 AMY C. NAGEL P.T.
Individual
Physical Therapist324 ROXBURY RD
ROCKFORD, IL 61107
(815) 398-9491
1255440871MRS. MAUREEN ELIZABETH NICOLLS MSPT
Individual
Physical Therapist324 ROXBURY RD
ROCKFORD, IL 61107
(815) 398-9491
1952403347 COLLEEN M. FERGUSON O.T.
Individual
Occupational Therapist324 ROXBURY RD
ROCKFORD, IL 61107
(815) 398-9491
1063633048 TANYA C. LIBBY P.T.
Individual
Physical Therapist324 ROXBURY RD
ROCKFORD, IL 61107
(815) 398-9491
1952571796 MICHAEL R BRUEMMER PTA
Individual
Physical Therapy Assistant324 ROXBURY RD
ROCKFORD, IL 61107
(815) 398-9491
1083857924 CINDY L FEARN A.P.N.
Individual
Clinical Nurse Specialist (Occupational Health)324 ROXBURY RD
ROCKFORD, IL 61107
(815) 398-9491
1669601852MR. MARK ROBERT ROBINSON ATC, CSCS
Individual
Specialist/Technologist (Athletic Trainer)324 ROXBURY RD
ROCKFORD, IL 61107
(815) 398-9491
1801109301MR. JOHN T BRINKMANN CPO, LPO, FAAOP
Individual
Prosthetist324 ROXBURY RD
ROCKFORD, IL 61107
(815) 398-9491
1063472751 JIMMY L WALKER JR. PA-C
Individual
Physician Assistant (Surgical)324 ROXBURY RD
ROCKFORD, IL 61107
(815) 381-7431
1760776884DR. AMIE LEHMAN HARACZ D.P.M.
Individual
Podiatrist (Foot & Ankle Surgery)324 ROXBURY RD
ROCKFORD, IL 61107
(815) 381-7339
1053696971 CARLY ANNE JACKSON PA-C
Individual
Physician Assistant324 ROXBURY RD
ROCKFORD, IL 61107
(815) 398-9491
1740396647 KATHLEEN A. LARSON O.T.
Individual
Occupational Therapist324 ROXBURY RD
ROCKFORD, IL 61107
(815) 381-7431
1427164359 JENNIFER E. BETO O.T.
Individual
Occupational Therapist324 ROXBURY RD
ROCKFORD, IL 61107
(815) 381-7431
1639414956 ANDREW FLEMING PT
Individual
Physical Therapist324 ROXBURY RD
ROCKFORD, IL 61107
(815) 381-7431
1144649435 JENNIFER A PETERSEN O.T.R.
Individual
Occupational Therapist324 ROXBURY RD
ROCKFORD, IL 61107
(815) 381-7431
1124028287 RYAN R WESTERBERG PT
Individual
Physical Therapist (Orthopedic)324 ROXBURY RD
ROCKFORD, IL 61107
(815) 398-9491
1992726178MRS. LAURA ANN KARLS OT
Individual
Occupational Therapist324 ROXBURY RD
ROCKFORD, IL 61107
(815) 398-9491
1063527349 SEAN P MACKENZIE M.D.
Individual
Physical Medicine & Rehabilitation324 ROXBURY RD
ROCKFORD, IL 61107
(815) 398-9491

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053948521, enumerated in the NPI registry as an "individual" on March 25, 2020

The provider is located at 324 Roxbury Rd Rockford, Il 61107 and the phone number is (815) 398-9491

The provider's speciality is Physician Assistant with taxonomy code 363A00000X

The provider has more than 6 years of experience.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Dean Health. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $85.71 with an average copayment of $21.42 for new patient appointments. Established patients should expect a typical charge of $68.64 and an average copayment of 17.16. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Established patient office or other outpatient visit, 20-29 minutes, Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg, New patient office or other outpatient visit, 30-44 minutes and X-ray of wrist, minimum of 3 views.

The practitioner is affiliated to the following hospital(s): WAUKESHA MEMORIAL HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on March 25, 2020. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.