Edward R Lutkus, MD

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

048231 Issued in MI

Practice address

1234 Napier Ave
Saint Joseph, MI 49085-2112

Phone

(269) 983-8300

NPI assigned

Jun 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Emergency Health Partners Grand Haven PLC

  • Emergency Medicine Physician
  • Grand Haven, MI
  • NPI 1700950953
  NPD (past)
• Mercy Urgent Care

  • Urgent Care Clinic/Center
  • Muskegon, MI
  • NPI 1861432692
  NPD (past)
• Radiology Muskegon PC

  • Diagnostic Radiology Physician
  • Muskegon, MI
  • NPI 1841208071
  NPD (past)
• Epmg of Ohio Inc P a

  • Emergency Medicine Physician
  • Portsmouth, OH
  • NPI 1841232196
  NPD (past)

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1144265083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 GREEN RD",
            "address_2": "SUITE 300",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-983-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTKUS",
        "first_name": "EDWARD",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "048231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2585069",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "EL048231",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4700212",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4700240",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3047753",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3404097",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsia Marie Love, CNM
• Keith Lovell, P.A.
• Jacqueline Veronica Lowe, DNP
• Danielle Lower, O.D.
• Gary Ludwig, O.D.
• Kathryn Marie Lutz, PA-C
• Pierre Luyckx, DPT
• Evan Lytle, D.O
• Matthew Alan Mabry, ATC, CSCS
• Rebecca Maccart

• Emergency Medical Services (Emergency Medicine) Physician in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.