Individual provider Active NPI

Rebekah Lutkoff, PNP, NPP

  • Psychiatric/Mental Health Nurse Practitioner
  • Amherst, NY
National Provider Identifier
1093190639
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
406431 Issued in NY
Practice address
1404 Sweet Home Rd Ste 2
Amherst, NY 14228-2778
Phone
(716) 796-9524
Fax
(716) 468-6806
NPI assigned
Jul 24, 2015
Last updated
Sep 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 382555 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 406431 NY Primary

Addresses

Primary practice location

1404 Sweet Home Rd Ste 2
Amherst, NY 14228-2778

Mailing address

64 Wiltshire Rd
Buffalo, NY 14221-4945
Phone (716) 796-9524

Other practice location 1

2400 Pine Ave
Niagara Falls, NY 14301-2402
Phone (716) 505-1060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20171027001300 NY Practitioner - Nurse Practitioner 6709152267

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
382555NYMDPediatric Nurse Practitioner
406431NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Health Services Inc CurrentSince May 1, 2025 Accepting new patients

Locations

3020 Bailey Ave
Cheektowaga, NY 14215
Phone (716) 831-0200

55 Dodge Rd
Getzville, NY 14068
Phone (716) 650-5100

2400 Pine Ave
Niagara Falls, NY 14301
Phone (716) 282-1114

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEGDAA

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.

NPI Registry JSON

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1093190639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 WILTSHIRE RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142214945",
            "telephone_number": "716-796-9524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 SWEET HOME RD STE 2",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142282778",
            "telephone_number": "716-796-9524",
            "fax_number": "716-468-6806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Pine Ave",
            "address_purpose": "LOCATION",
            "city": "Niagara Falls",
            "state": "NY",
            "postal_code": "143012402",
            "country_code": "US",
            "telephone_number": "716-505-1060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTKOFF",
        "first_name": "REBEKAH",
        "credential": "PNP, NPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-24",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "382555",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "406431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.