Gordon D Lutchman

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD456515 Issued in PA

Practice address

8352 Bustleton Ave
Philadelphia, PA 19152-1909

Phone

(215) 809-1445

Fax

(224) 235-4652

NPI assigned

Aug 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Vascular Surgery

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Newark Vein and Vascular Center LLCGroup PAC ID 7911327465, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13207/brand/1/csg/1/fhir/r4
• Direct secure messaging: gordonlutchman@mai.allscriptsdirect.net

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.

• Newark Vein and Vascular Center LLC

  • Internal Medicine Physician
  • Newark, NJ
  • NPI 1174159982
  Medicare reassignment Care Compare group NPD
• Call to Care LLC

  • Multi-Specialty Clinic/Center
  • Orange, NJ
  • NPI 1265063846
  Medicare reassignment NPD
• Metropolitan Medical Group LLC

  • Internal Medicine Physician
  • East Orange, NJ
  • NPI 1700442415
  Medicare reassignment NPD
• North Ward Medical Arts LLC

  • Internal Medicine Physician
  • Newark, NJ
  • NPI 1538790563
  Medicare reassignment NPD
• Roseville Medical Society LLC

  • Internal Medicine Physician
  • Newark, NJ
  • NPI 1275168320
  Medicare reassignment NPD
• Salerno Medical Associates, LLC

  dba Prospect Spine and Pain

  • Internal Medicine Physician
  • East Orange, NJ
  • NPI 1184766107
  Medicare reassignment NPD
• Senior Healthcare Outreach Program

  • Geriatric Medicine (Internal Medicine) Physician
  • East Orange, NJ
  • NPI 1588707954
  Medicare reassignment NPD
• Maimonides Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1093777492
  NPD
• Broad Street Professional Medical Services LLC

  • Vascular Surgery Physician
  • Philadelphia, PA
  • NPI 1720630650
  NPD (past)
• Advanced Vascular Solutions, P.a.

  • Vascular & Interventional Radiology Physician
  • Tinton Falls, NJ
  • NPI 1033142328
  NPD (past)
• Coney Island Medical Practice Plan, P.C.

  • General Practice Physician
  • Brooklyn, NY
  • NPI 1386951762
  NPD (past)
• Laser and Varicose Vein Treatment Center of Staten Island LLP

  • Vascular Surgery Physician
  • Staten Island, NY
  • NPI 1558450312
  NPD (past)

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1548270861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600650791",
            "telephone_number": "847-593-8460",
            "fax_number": "224-235-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8352 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191521909",
            "telephone_number": "215-809-1445",
            "fax_number": "224-235-4652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "766 Shrewsbury Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Tinton Falls",
            "state": "NJ",
            "postal_code": "077243001",
            "country_code": "US",
            "telephone_number": "732-345-8346",
            "fax_number": "224-235-4652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTCHMAN",
        "first_name": "GORDON",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA04510100",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NY",
            "license": "164843-1",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD456515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01034257",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0533033",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031022030001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy B Lustig, DPM
• Amy Patricia Lustig, PHD, MPH, CCC-SLP
• Elizabeth Burgess Lustig
• Eric Steven Lustig, D.P.M.
• Robert Allen Lustig, MD
• Waseem Lutfi, MD
• Stephanie Luther
• Erika Lutins, MD
• Jessica Lutz
• John P Lutz, MCAT

• Surgery Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; 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.