Individual provider Active NPI

Brittany Lautz, FNP-C

  • Family Nurse Practitioner
  • Media, PA
National Provider Identifier
1346610359
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP015514 Issued in PA
Practice address
1088 W Baltimore Pike Ste 2104
Riddle HCC #2
Media, PA 19063-5136
Phone
(610) 744-2980
Fax
(610) 744-2982
NPI assigned
Oct 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN625373 PA
Family Nurse Practitioner 363LF0000X SP015514 PA Primary

Addresses

Primary practice location

1088 W Baltimore Pike Ste 2104
Riddle HCC #2
Media, PA 19063-5136

Mailing address

1088 W Baltimore Pike Ste 2104
Riddle HCC #2
Media, PA 19063-5136
Phone (610) 744-2980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170126001627 PA Practitioner - Nurse Practitioner 8123300167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

201 2ND Ave
Collegeville, PA 19426-3613
Phone (610) 489-7703

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN625373PAMDRegistered Nurse
SP015514PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare CurrentSince Jan 3, 2017 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

1088 W Baltimore Pike
Ste 2104
Media, PA 19063
Phone (484) 227-0130

1088 W Baltimore Pike
Ste 2208
Media, PA 19063
Phone (610) 891-3049

Organizations & group practices 1

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 5

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": "1443744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1346610359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1088 W BALTIMORE PIKE STE 2104",
            "address_2": "RIDDLE HCC #2",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635136",
            "telephone_number": "610-744-2980",
            "fax_number": "610-744-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088 W BALTIMORE PIKE STE 2104",
            "address_2": "RIDDLE HCC #2",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635136",
            "telephone_number": "610-744-2980",
            "fax_number": "610-744-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUTZ",
        "first_name": "BRITTANY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-02",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN625373",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP015514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.