Jaclyn Lutzow

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

SP026727 Issued in PA

Practice address

3509 N Broad St
Philadelphia, PA 19140-4105

Phone

(215) 707-7200

NPI assigned

Jan 6, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Jefferson Medical College of Thomas Jefferson University, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Temple University Hospital Hospital, Philadelphia, PA, CCN 390027

Merit-based Incentive Payment System (MIPS)

Final score

81.21 of 100Reported as group

Quality

49.71

Promoting interoperability

100

Improvement activities

40

Cost

74.23

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Temple Faculty Practice Plan Inc

  • Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1881176949
  Medicare reassignment Care Compare group NPD
• Temple Faculty Practice Plan Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Philadelphia, PA
  • NPI 1801378740
  NPD
• Temple Faculty Practice Plan Inc

  • Urology Physician
  • Voorhees, NJ
  • NPI 1407638794
  NPD
• Temple Faculty Practice Plan Inc

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1285116228
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Temple University Hospital, Inc

  • Clinic/Center
  • Furlong, PA
  • NPI 1093404386

  Hospital

  Care Compare affiliation
• Temple University Hospital, Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1275157455
  Care Compare affiliation
• Temple University Hospital, Inc

  • Ambulatory Surgical Clinic/Center
  • Philadelphia, PA
  • NPI 1275682148

  Hospital

  Care Compare affiliation
• Temple University Hospital, Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1356981443
  Care Compare affiliation
• Temple University Hospital, Inc

  • Clinic/Center
  • East Norriton, PA
  • NPI 1407612922

  Hospital

  Care Compare affiliation
• Temple University Hospital, Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1871368654
  Care Compare affiliation
• Temple University Hospital, Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1932813789
  Care Compare affiliation
• Temple University Hospital, Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1962579029
  Care Compare affiliation

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1497469217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 EDMUND RD",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190012012",
            "telephone_number": "215-421-4339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404105",
            "telephone_number": "215-707-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZOW",
        "first_name": "JACLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP026727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Lutz, DNP, CRNA
• Rachel Lutz, MD
• Ronald Lutz Jr., MD
• Zachary Lutz, PA
• Robert Donald Lutzick Jr.
• Lynde Kintner Lutzow, MD
• Luu Drug Stores LLC
• Bao Tran Ngoc Luu
• Bryan Khang Luu, DO
• Hung Luu, PHARM.D

• Adult Health Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Adult Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.