Individual provider Active NPI

Matthew Anthony Lutz, PA-C

  • Physician Assistant
  • Boone, NC
National Provider Identifier
1417465550
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07793 Issued in NC
Practice address
965 State Farm Rd
Boone, NC 28607-4948
Phone
(828) 264-2340
NPI assigned
Jan 10, 2018
Last updated
May 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-07793 NC Primary

Addresses

Primary practice location

965 State Farm Rd
Boone, NC 28607-4948

Mailing address

965 State Farm Rd
Boone, NC 28607-4948
Phone (828) 264-2340

Other practice location 1

336 Deerfield Rd
Boone, NC 28607-5008
Phone (828) 262-4100

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180312001604 NC Practitioner - Physician Assistant 2769744655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appalachian Regional Medical Associates IncGroup PAC ID 5799877817, 147 clinicians

Practice addresses (Care Compare)

211 Milton Brown Heirs Rd
Boone, NC 28607-8708
Phone (828) 265-2159

336 Deerfield Rd
Boone, NC 28607-5008
Phone (828) 262-4100

935 State Farm Rd
Suite 101
Boone, NC 28607-4948
Phone (828) 264-5150

965 State Farm Rd
Boone, NC 28607-4948
Phone (828) 264-2340

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-07793NCMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: matthewlutz@arhs.allscriptsdirect.net
  • Direct secure messaging: mlutz1013858@direct.unc.nchie.net

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

Hospital & facility affiliations 3

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": "1515542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1417465550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 STATE FARM RD",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074948",
            "telephone_number": "828-264-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 STATE FARM RD",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074948",
            "telephone_number": "828-264-2340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "336 Deerfield Rd",
            "address_purpose": "LOCATION",
            "city": "Boone",
            "state": "NC",
            "postal_code": "286075008",
            "country_code": "US",
            "telephone_number": "828-262-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "MATTHEW",
        "middle_name": "ANTHONY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-10",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

Verify at the official NPI Registry.