NPIMap

Individual provider Active NPI

Lauren Jutras, MD

  • Diagnostic Radiology Physician
  • Norfolk, VA
National Provider Identifier
1457911885
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0116034532 Issued in VA
Practice address
825 Fairfax Ave
Norfolk, VA 23507-1914
Phone
(757) 446-6190
NPI assigned
Jun 18, 2019
Last updated
Mar 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0116034532 VA Primary
Surgery Physician 208600000X LL82787 SC

Addresses

Primary practice location

825 Fairfax Ave
Norfolk, VA 23507-1914

Mailing address

PO Box 1980
Norfolk, VA 23501-1980
Phone (757) 388-1141

Other practice location 1

169 Ashley Ave
Room 202 MSC333
Charleston, SC 29425
Phone (843) 792-4638

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251217001233 SC Practitioner - Diagnostic Radiology 0042540478 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical University of South Carolina College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pelican II LLCGroup PAC ID 1759484082, 18 clinicians
Charleston Radiologists PAGroup PAC ID 9436054715, 35 clinicians

Practice addresses (Care Compare)

1241 Woodland Ave
Mt Pleasant, SC 29464-3288
Phone (843) 881-4020

2550 Elms Ctr Rd
North Charleston, SC 29406-9844
Phone (866) 717-9687

295 Midland Pkwy
Summerville, SC 29485-8104
Phone (866) 717-9687

501 Robertson Blvd
Walterboro, SC 29488-2787
Phone (866) 717-9687

8330 Medical Plaza Dr
Charleston, SC 29406-9104
Phone (866) 717-9687

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0116034532VAMDDiagnostic Radiology Physician
LL82787SCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Radiologists PA Diagnostic Radiology CurrentSince Sep 11, 2025 Accepting new patients
Pelican II, LLC Diagnostic Radiology CurrentSince Sep 11, 2025 Accepting new patients

Locations

1241 Woodland Ave
Mt Pleasant, SC 29464
Phone (843) 881-4020

Interoperability endpoints

  • Direct secure messaging: ljutras897452@direct.emory.org

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

Hospital & facility affiliations 9

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": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1457911885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1980",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235011980",
            "telephone_number": "757-388-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-446-6190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Ashley Ave",
            "address_2": "Room 202 MSC333",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "29425",
            "country_code": "US",
            "telephone_number": "843-792-4638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUTRAS",
        "first_name": "LAUREN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0116034532",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "LL82787",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.