Individual provider Active NPI

John M. Lujanac, APRN

  • Family Nurse Practitioner
  • Sandy Hook, CT
National Provider Identifier
1043213788
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
002370 Issued in CT
Practice address
107 Church Hill Rd
Sandy Hook, CT 06482-1194
Phone
(203) 257-3130
Fax
(877) 529-2920
NPI assigned
May 25, 2005
Last updated
Feb 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 002370 CT Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2370 CT

Addresses

Primary practice location

107 Church Hill Rd
Sandy Hook, CT 06482-1194

Mailing address

68 Walnut Tree Hill Rd
Sandy Hook, CT 06482-1073
Phone (203) 257-3130

Other identifiers 1

IdentifierTypeStateIssuer
004218766MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040629000779 CT Practitioner - Nurse Practitioner 7012993074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

107 Church Hill Rd
Suite 2a
Sandy Hook, CT 06482-1194
Phone (203) 304-1981

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
002370CTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sandy Hook Behavioral Health LLC Family CurrentSince Oct 14, 2023 Accepting new patients
NP Care, LLC Past Accepting new patients
NP Care, LLC Past Accepting new patients
Medoptions Behavioral Health Assoc, LLC Past Accepting new patients
Masonicare Primary Care Physicians PastSince Oct 1, 2001 Accepting new patients
Masonicare Behavioral Health, LLC PastSince Dec 17, 2007 Accepting new patients

Locations

107 Church Hill Rd
Bldg A
Sandy Hook, CT 06482

107 Church Hill Rd
Ste 2A
Sandy Hook, CT 06482
Phone (203) 304-1981

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1116979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1043213788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 WALNUT TREE HILL RD",
            "city": "SANDY HOOK",
            "state": "CT",
            "postal_code": "064821073",
            "telephone_number": "203-257-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CHURCH HILL RD",
            "city": "SANDY HOOK",
            "state": "CT",
            "postal_code": "064821194",
            "telephone_number": "203-257-3130",
            "fax_number": "877-529-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUJANAC",
        "first_name": "JOHN",
        "middle_name": "M.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-25",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "002370",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "2370",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004218766",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy Hook, CT

Sources for this page

Verify at the official NPI Registry.