Individual provider Active NPI

Kristen Linda Luttenberger, APN-C

  • Acute Care Nurse Practitioner
  • Paterson, NJ
National Provider Identifier
1285060814
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NJ00433700 Issued in NJ
Practice address
703 Main St
Paterson, NJ 07503-2621
Phone
(973) 754-2000
NPI assigned
Sep 14, 2013
Last updated
Aug 6, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 26NJ00433700 NJ Primary

Addresses

Primary practice location

703 Main St
Paterson, NJ 07503-2621

Mailing address

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-4399

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140117000727 NJ Practitioner - Nurse Practitioner 7012145105 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Physicians Healthcare Group IncGroup PAC ID 2567645401, 25 clinicians

Practice addresses (Care Compare)

1040 Main St
FL 2
Paterson, NJ 07503-2212
Phone (973) 754-2052

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00433700NJMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Josephs Physicians Healthcare Group Inc CurrentSince Aug 1, 2015 Accepting new patients
St. Joseph's Healthcare, Inc. CurrentSince Jan 1, 2014 Accepting new patients

Locations

1040 Main St
Fl 2
Paterson, NJ 07503
Phone (718) 986-0781

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240

999 McBride Ave
Ste B204
Woodland Park, NJ 07424
Phone (973) 256-5667

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1379116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1285060814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTTENBERGER",
        "first_name": "KRISTEN",
        "middle_name": "LINDA",
        "name_prefix": "Mrs.",
        "credential": "APN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-14",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ00433700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.