Individual provider Active NPI

Patricia F Lutz, RN

  • Registered Nurse
  • Staten Island, NY
National Provider Identifier
1578849311
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
325331-1 Issued in NY
Practice address
77 Chicago Ave
Staten Island, NY 10305-3757
Phone
(718) 442-7828
Fax
(718) 556-2516
NPI assigned
Oct 25, 2011
Last updated
Oct 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 325331-1 NY Primary

Addresses

Primary practice location

77 Chicago Ave
Staten Island, NY 10305-3757

Mailing address

60 Josephine St
Staten Island, NY 10314-4033
Phone (718) 564-4547

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
325331-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1578849311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 JOSEPHINE ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144033",
            "telephone_number": "718-564-4547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 CHICAGO AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053757",
            "telephone_number": "718-442-7828",
            "fax_number": "718-556-2516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "PATRICIA",
        "middle_name": "F",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-25",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "325331-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.