Shannon Kirby Lutz, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00463000 Issued in NJ

Practice address

150 Delsea Dr Ste B
Sewell, NJ 08080-9478

Phone

(856) 302-0500

NPI assigned

Oct 11, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Advocare, LLCGroup PAC ID 3678562188, 383 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
• Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
• Inspira Medical Center Mullica Hill Hospital, Elmer, NJ, CCN 310069
• Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannon.lutzpac.p1@direct.arthritispa.nextgenshare.com

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.

• Advocare, LLC

  • Pediatrics Physician
  • Marlton, NJ
  • NPI 1770538696
  Medicare reassignment Care Compare group NPD
• Advocare , LLC

  dba Advocare Berlin Medical Associates (DME)

  • Internal Medicine Physician
  • Manahawkin, NJ
  • NPI 1912762162
  NPD
• Advocare, LLC

  dba Advocare Merchantville Pediatrics

  • Pediatrics Physician
  • Cherry Hill, NJ
  • NPI 1780696732
  NPD (past)
• CMG Medical Group I LLC

  • Family Medicine Physician
  • Manalapan, NJ
  • NPI 1942778014
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Inspira Medical Centers, Inc.

  dba Inspira Medical Center Elmer

  • General Acute Care Hospital
  • Elmer, NJ
  • NPI 1255396024
  Care Compare affiliation
• Inspira Medical Centers, Inc.

  dba Inspira Medical Center Mullica Hill

  • General Acute Care Hospital
  • Mullica Hill, NJ
  • NPI 1366097032
  Care Compare affiliation
• South Jersey Hospital, Inc.

  dba SJH Sports Rehab Care - Tomlin Station

  • Physical Therapy Clinic/Center
  • Mullica Hill, NJ
  • NPI 1609158732

  Hospital

  Care Compare affiliation
• Virtua - Memorial Hospital Burlington County, Inc.

  dba Virtua Mount Holly Hospital

  • General Acute Care Hospital
  • Mount Holly, NJ
  • NPI 1134125016
  Care Compare affiliation
• Virtua - West Jersey Health System, Inc.

  • General Acute Care Hospital
  • Voorhees, NJ
  • NPI 1528064409
  Care Compare affiliation
• Virtua Our Lady of Lourdes Hospital Inc

  dba Virtua Our Lady of Lourdes Hospital

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1235134024
  Care Compare affiliation

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1275043705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ROUTE 73 N STE 320",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 DELSEA DR STE B",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080809478",
            "telephone_number": "856-302-0500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2360 Maryland Rd",
            "address_purpose": "LOCATION",
            "city": "Willow Grove",
            "state": "PA",
            "postal_code": "19090",
            "country_code": "US",
            "telephone_number": "215-657-6776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "SHANNON",
        "middle_name": "KIRBY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-11",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA059371",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00463000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shannon.lutzpac.p1@direct.arthritispa.nextgenshare.com",
            "affiliation": "Y",
            "affiliationName": "RHEUMATIC DISEASE ASSOCIATES,LTD",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2360 Maryland Rd",
            "city": "Willow Grove",
            "state": "PA",
            "country_code": "US",
            "postal_code": "19090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robin L Love, VMD
• Jonathan Low
• Charmaine Luceniada, OTR/L
• Elena Mihaela Lumezanu, MD
• Casey L Lunstead, LSW
• Waverly Anne Lutz, WHNP, CNM
• Stacey A. Macpaintsil-Ostrom, MSN, APN, PMHNP-BC
• Christopher Macphee
• Colleen Madden, M.A CCC-SLP
• Mario L Maiese, DO

• Medical Physician Assistant in Sewell, NJ
• Providers in Sewell, NJ by specialty
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.