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Kenneth Mutia
NPI 1518792704 · Physician Assistant · Fort Drum, NY
Kenneth Mutia is a Physician Assistant provider in Fort Drum, NY (NPI 1518792704).
Provider details
- NPI number
- 1518792704
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Basic profile(49/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603
Phone: (315) 772-8813
Approximate (ZIP-level) locationGet directions
Mailing address
8640 Peck St
Evans Mills, NY 13637-7709
Registry dates
- Enumerated
- 2024-09-06
- Last updated
- 2025-12-16
- Certified
- 2025-12-16
Frequently asked questions
- What is Kenneth Mutia's NPI number?
- Kenneth Mutia's National Provider Identifier (NPI) is 1518792704, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kenneth Mutia's specialty?
- Kenneth Mutia is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Kenneth Mutia located?
- Kenneth Mutia's practice location on file with NPPES is 11050 Mt Belvedere Blvd, Fort Drum, NY 13602-2603.
- What is Kenneth Mutia's phone number?
- The practice phone number listed in the NPPES registry for Kenneth Mutia is (315) 772-8813.
- Is Kenneth Mutia's NPI active?
- Yes — Kenneth Mutia's NPI (1518792704) is active in the NPPES registry as of the last update on 2025-12-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.