NPIMap

Individual provider Active NPI

Brant Joseph Lutsi, M.D.

  • Gastroenterology Physician
  • Woodland, CA
National Provider Identifier
1265608186
Registry record updated Oct 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
105415 Issued in CA
Practice address
1321 Cottonwood St
Suite 203
Woodland, CA 95695-5131
Phone
(530) 668-2600
Fax
(530) 662-7330
NPI assigned
Apr 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036113495 IL
Gastroenterology Physician 207RG0100X 105415 CA Primary

Addresses

Primary practice location

1321 Cottonwood St
Suite 203
Woodland, CA 95695-5131

Mailing address

5328 Rogers St
Davis, CA 95618-7203
Phone (312) 339-7290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150910001869 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 9335384890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Northeastern Ohio University College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gi Partners of Illinois PLLCGroup PAC ID 2567758295, 38 clinicians

Practice addresses (Care Compare)

1880 W Winchester Rd
Suite 201
Libertyville, IL 60048-5336
Phone (630) 952-1400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy152
Upper gastrointestinal (GI) endoscopy for acid reflux125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
105415CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gi Partners of Illinois, PLLC Gastroenterology CurrentSince Jan 1, 2017 Accepting new patients
Gip Anesthesia Services PLLC PastSince May 8, 2022 Accepting new patients

Locations

350 E Congress Pkwy
Ste D
Crystal Lake, IL 60014
Phone (847) 639-2999

22285 N Pepper Rd
Ste 311
Lake Barrington, IL 60010
Phone (847) 382-4410

22285 N Pepper Rd
Ste 312
Lake Barrington, IL 60010
Phone 84738206793336

1880 W Winchester Rd
Ste 201
Libertyville, IL 60048
Phone (847) 247-0187

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

Interoperability endpoints

  • Direct secure messaging: blutsi236341@direct.myadvocateaurora.org

Organizations & group practices 2

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.

Hospital & facility affiliations 8

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": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1265608186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5328 ROGERS ST",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956187203",
            "telephone_number": "312-339-7290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 COTTONWOOD ST",
            "address_2": "SUITE 203",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956955131",
            "telephone_number": "530-668-2600",
            "fax_number": "530-662-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTSI",
        "first_name": "BRANT",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036113495",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "105415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland, CA

Sources for this page

Verify at the official NPI Registry.