Individual provider Active NPI

Lucia M Moutoux, CRNP

  • Family Nurse Practitioner
  • Greenbelt, MD
National Provider Identifier
1063191112
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R212190 Issued in MD
Practice address
7500 Greenway Center Dr
Greenbelt, MD 20770-3502
Phone
(301) 220-2333
Fax
(301) 220-2339
NPI assigned
Jul 17, 2023
Last updated
Aug 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R212190 MD Primary

Addresses

Primary practice location

7500 Greenway Center Dr
Greenbelt, MD 20770-3502

Mailing address

4913 Mariners Dr
Shady Side, MD 20764-9752
Phone (443) 848-8278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20231214001956 DC Practitioner - Nurse Practitioner 6305291030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Maryland School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pain Management Associates, LLCGroup PAC ID 0547285314, 4 clinicians

Practice addresses (Care Compare)

7300 Hanover Dr
Suite 204
Greenbelt, MD 20770-2247
Phone (301) 220-2333

Hospital & facility affiliations

  • Homecall Home health agency, Easton, MD, CCN 217066

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Management Associates, LLC CurrentSince Dec 1, 2023 Accepting new patients

Locations

7300 Hanover Dr
Ste 204
Greenbelt, MD 20770
Phone (240) 297-9016

Interoperability endpoints

  • Direct secure messaging: lucia.moutoux@2413.securemail.prognocis.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1063191112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4913 MARINERS DR",
            "city": "SHADY SIDE",
            "state": "MD",
            "postal_code": "207649752",
            "telephone_number": "443-848-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 GREENWAY CENTER DR",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703502",
            "telephone_number": "301-220-2333",
            "fax_number": "301-220-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUTOUX",
        "first_name": "LUCIA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R212190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbelt, MD

Sources for this page

Verify at the official NPI Registry.