Joseph C Lutka Jr.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

152514 Issued in TX

Practice address

4609 County Road 919
Crowley, TX 76036-5535

Phone

(817) 426-9355

Fax

(817) 426-9357

NPI assigned

Aug 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

Practice roles

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

• Suretest Laboratory,LLC

  • Clinical Medical Laboratory
  • Crowley, TX
  • NPI 1962723379
  NPD (past) Authorized official

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262044800000",
    "number": "1083806178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4609 COUNTY ROAD 919",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760365535",
            "telephone_number": "817-426-9355",
            "fax_number": "817-426-9357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4609 COUNTY ROAD 919",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760365535",
            "telephone_number": "817-426-9355",
            "fax_number": "817-426-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTKA",
        "first_name": "JOSEPH",
        "middle_name": "C",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2009-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": "152514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1839078",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE  (PTAN)",
            "identifier": "CL1045",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Leigh Ledesma, DDS
• Life Changing Christian Counseling
• Clara Livingston, CMSRN, PCCN
• LMC Transport
• Greta Lodrigues
• Thomas B Macalik, LPC
• Donald Alastair Macleod, MS LMFT
• Edward M Maina
• Maggie Mankarious, PHARMACIST
• Paula Michelle Manning, LPC

• All providers in Crowley, TX
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.