Marc Lutz, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11023551 Issued in FL

Practice address

18031 Adrift Rd
Winter Garden, FL 34787-8471

Phone

(407) 205-8822

Fax

(866) 404-4006

NPI assigned

Dec 9, 2022

Last updated

Jul 13, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Brave Health Inc.

  • Community/Behavioral Health Agency
  • Miami, FL
  • NPI 1821588674
  Medicare reassignment

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1366153413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18031 ADRIFT RD",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347878471",
            "telephone_number": "407-205-8822",
            "fax_number": "866-404-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18031 ADRIFT RD",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347878471",
            "telephone_number": "407-205-8822",
            "fax_number": "866-404-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "MARC",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-09",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11023551",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9485045",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Dawn Lucas, SLP
• Megan Luciano, MD
• Johanna Lugo Gonzalez, AUD
• Michael W Lugo, PTA, LMT, CPT
• Luna Nueva Therapy & Consulting LLC
• Luxottica of America Inc (Lenscrafters #5228)
• Luxottica Retail North America Inc (Target Optical #C4422)
• M & H Dental Group PLLC
• Sabrine Amjad Maali
• Macali Eye Clinic, PA

• Psychiatric/Mental Health Nurse Practitioner in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; 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.