NPIMap

Individual provider Active NPI

Brooke Utzat, PAC

  • Physician Assistant
  • Bartonsville, PA
National Provider Identifier
1467040279
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA062207 Issued in PA
Practice address
3565 Route 611 Ste 300
Bartonsville, PA 18321-7800
Phone
(484) 526-2598
Fax
(866) 522-4710
NPI assigned
Jan 7, 2021
Last updated
Apr 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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 MA062207 PA Primary

Addresses

Primary practice location

3565 Route 611 Ste 300
Bartonsville, PA 18321-7800

Mailing address

3565 Route 611 Ste 300
Bartonsville, PA 18321-7800
Phone (484) 526-2598

Other names 1

  • Brooke Lutz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210128000771 PA Practitioner - Physician Assistant 9739593054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

3565 Route 611
Suite 300
Bartonsville, PA 18321-7800
Phone (484) 526-2200

801 Ostrm St
Bethlehem, PA 18015-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Physician Group Inc CurrentSince Feb 22, 2021 Accepting new patients
St Luke's Physician Group Inc CurrentSince Feb 22, 2021 Accepting new patients
St. Luke's Physician Group, Inc. Past Accepting new patients

Locations

3565 Route 611
Ste 300
Bartonsville, PA 18321
Phone (272) 212-0105

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Interoperability endpoints

  • Direct secure messaging: brooke.lutz@slpg.direct-sluhn.org

Organizations & group practices 4

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 10

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": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1467040279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3565 ROUTE 611 STE 300",
            "city": "BARTONSVILLE",
            "state": "PA",
            "postal_code": "183217800",
            "telephone_number": "484-526-2598",
            "fax_number": "866-522-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3565 ROUTE 611 STE 300",
            "city": "BARTONSVILLE",
            "state": "PA",
            "postal_code": "183217800",
            "telephone_number": "484-526-2598",
            "fax_number": "866-522-4710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTZAT",
        "first_name": "BROOKE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "LUTZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bartonsville, PA

Sources for this page

Verify at the official NPI Registry.