Active NPI
Ben H Lutz, PA-C
- Physician Assistant
- Redlands, CA
National Provider Identifier
1093922668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA14783
- Practice address
- 245 Terracina Blvd Ste 106C
Redlands, CA 92373-4899 - Phone
- (909) 748-6569
- NPI assigned
- May 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA14783 | CA | Primary |
Addresses
Primary practice location
245 Terracina Blvd Ste 106C
Redlands, CA 92373-4899
Mailing address
811 Wedgewood CT
Rialto, CA 92376-8714
Phone (909) 875-8451
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA14783 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bear Lake Professionals Inc | Current | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
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 and National Provider Directory roles.
-
dba Big Bear Urgent Care
- Urgent Care Clinic/Center
- Johns Island, SC
- NPI 1831386705
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093922668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "811 WEDGEWOOD CT",
"city": "RIALTO",
"state": "CA",
"postal_code": "923768714",
"telephone_number": "909-875-8451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 TERRACINA BLVD STE 106C",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923734899",
"telephone_number": "909-748-6569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTZ",
"first_name": "BEN",
"middle_name": "H",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA14783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
- Lunara Psychiatric Nursing Inc (Lunara Psychiatry)
- John L Lund, D.C.
- Jennifer Luong, D.O.
- Michelle Luther, DPT
- Erin Luttringer, RN
- Michael Gordon Lutz, OTRL
- Allison Luu, PHARM D
- Luxottica of America Inc (Target Optical #E874)
- Luzviminda V Dayrit DDS Inc (Pavilion Smile Dental Care)
- Devin Paul Lynch, LNMT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.