Active NPI
Sean Lutmer, D.O.
- Ophthalmology Physician
- Martinez, GA
National Provider Identifier
1396087946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 1324
- Practice address
- 3631 Pebble Beach Dr
Martinez, GA 30907-9087 - Phone
- (903) 253-4525
- NPI assigned
- Mar 21, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Ophthalmology Physician | 207W00000X | 1324 | NE | Primary |
Addresses
Primary practice location
3631 Pebble Beach Dr
Martinez, GA 30907-9087
Mailing address
3631 Pebble Beach Dr
Martinez, GA 30907-9087
Phone (903) 253-4525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201111002471 | GA | Order and Referring Only - Ophthalmology | 5395155824 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1324 | NE | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740614400000",
"number": "1396087946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3631 PEBBLE BEACH DR",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "309079087",
"telephone_number": "903-253-4525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3631 PEBBLE BEACH DR",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "309079087",
"telephone_number": "903-253-4525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTMER",
"first_name": "SEAN",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-03-21",
"last_updated": "2025-02-27",
"certification_date": "2025-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NE",
"license": "1324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.