Individual provider Active NPI

Rodney S Lutz, M.D.

  • Surgery Physician
  • Raleigh, NC
National Provider Identifier
1316917610
Registry record updated Mar 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
200100571 Issued in NC
Practice address
3410 Six Forks Rd
Raleigh, NC 27609-7234
Phone
(919) 571-1170
Fax
(919) 783-7743
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 200100571 NC Primary

Addresses

Primary practice location

3410 Six Forks Rd
Raleigh, NC 27609-7234

Mailing address

PO Box 20127
Raleigh, NC 27619-0127
Phone (919) 571-1170

Other identifiers 1

IdentifierTypeStateIssuer
891285YMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031210000779 NC Practitioner - General Surgery 8426953936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Ohio Medical University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

2800 Blue Ridge Rd
Suite 300
Raleigh, NC 27607-6476
Phone (919) 784-7874

Hospital & facility affiliations

  • 3HC Home health agency, Goldsboro, NC, CCN 347104
  • Rex Hospital Hospital, Raleigh, NC, CCN 340114
  • Johnston Health Hospital, Smithfield, NC, CCN 340090

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal30
Melanoma (skin cancer) excision1-10
Removal of tissue426
Removal of skin lesions13
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200100571NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina MG, LLC Surgery CurrentSince Jun 1, 2025 Accepting new patients
Rex Hospital Inc Past Accepting new patients

Locations

1505 SW Cary Pkwy
Ste 302
Cary, NC 27511
Phone (919) 367-2580

781 Avent Ferry Rd
Ste 214
Holly Springs, NC 27540
Phone (919) 567-6133

6602 Knightdale Blvd
Ste 201
Knightdale, NC 27545
Phone (919) 747-5270

6602 Knightdale Blvd
Ste 110
Knightdale, NC 27545
Phone (919) 747-5300

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

2800 Blue Ridge Rd
Ste 300
Raleigh, NC 27607
Phone (919) 784-8346

Interoperability endpoints

  • Direct secure messaging: rlutz11642@direct.unc.nchie.net

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 4

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268784000000",
    "number": "1316917610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20127",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276190127",
            "telephone_number": "919-571-1170",
            "fax_number": "919-783-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 SIX FORKS RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097234",
            "telephone_number": "919-571-1170",
            "fax_number": "919-783-7743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "RODNEY",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2010-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "200100571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891285Y",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.