Micah Lynn Ann Clutter
NPI 1053948521ActiveIndividual· Physician Assistant· Rockford, IL
Physician Assistant with Orthopaedic Associates of Wisconsin SC, practicing in Rockford, Illinois. 96 Medicare patients in 2024, $10,501 paid; all of their 140 Part D prescriptions were generic. Lists Waukesha Memorial Hospital as a hospital affiliation.
Overview
| NPI | 1053948521 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Mar 25, 2020 |
| Last updated in NPPES | Jul 30, 2020 |
| Certified by provider | Jul 30, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 085-007766 | IL |
| Specialist/Technologist, Athletic Trainer | 2255A2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (WI) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 96 |
|---|---|
| Services billed | 273 across 36 procedure codes |
| Paid by Medicare | $10,501 |
Part D prescriptions in 2024
| Prescriptions (claims) | 140 · 140 30-day fills |
|---|---|
| Patients | 113 |
| Total drug cost | $591.34 |
| Generic share | 100% of claims |
Education and affiliations
| Graduation year | 2020 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Orthopaedic Associates of Wisconsin SCPewaukee, WI · 109 clinicians
Hospital affiliation
- Waukesha Memorial HospitalWaukesha, WI
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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