Jeffrey K. Luttrull, M. D. a Professional Corporation

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

JEFFREY K. LUTTRULL, M. D. A PROFESSIONAL CORPORATION

Practice address

3160 Telegraph Rd Ste 230
Ventura, CA 93003-3252

Phone

(805) 650-0664

NPI assigned

Feb 15, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jeffrey Kevin LuttrullNPI 1477573319

Title

President

Phone

(805) 650-0664

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey K Luttrull, M.D

  • Ophthalmology Physician
  • Ventura, CA
  • NPI 1477573319
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1003084674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 TELEGRAPH RD STE 230",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033252",
            "telephone_number": "805-650-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 TELEGRAPH RD STE 230",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033252",
            "telephone_number": "805-650-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY K. LUTTRULL, M. D. A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LUTTRULL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-650-0664",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7015319",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Ventura, CA
• Providers in Ventura, CA by specialty
• Preferred Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.