Nicole K. Luetke, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS012680 Issued in PA

Practice address

721 Skippack Pike
Suite 3
Blue Bell, PA 19422-1700

Phone

(215) 793-0600

Fax

(215) 793-0759

NPI assigned

May 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 9

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Philadelphia College of Osteopathic Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

LMG Family Practice PCGroup PAC ID 1759286172, 11 clinicians

Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Home Health Home health agency, Newtown, PA, CCN 397015
• Jefferson Einstein Montgomery Hospital Hospital, East Norriton, PA, CCN 390329
• St Luke'S Hospital - Grand View Campus Hospital, Sellersville, PA, CCN 390057
• Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
• Jefferson Einstein Philadelphia Hospital Hospital, Philadelphia, PA, CCN 390142

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicole.luetke@direct.einstein.edu
• Direct secure messaging: nicole.luetke.p1@direct.lmg.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• LMG Family Practice PC

  • Family Medicine Physician
  • Lansdale, PA
  • NPI 1114971553
  Medicare reassignment Care Compare group NPD
• LMG Family Practice

  • Chiropractor
  • Lansdale, PA
  • NPI 1407979503
  NPD (past)

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

• Einstein Hospital

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1366653818
  Care Compare affiliation Name & address match
• Einstein Medical Center Montgomery

  • General Acute Care Hospital
  • East Norriton, PA
  • NPI 1104192590
  Care Compare affiliation
• Hospital of the University of PA

  • Ambulatory Fertility Facility
  • Phila, PA
  • NPI 1033262316

  Hospital

  Care Compare affiliation
• Mercy Home Health

  • Home Health Agency
  • Newtown, PA
  • NPI 1467412296
  Care Compare affiliation
• St. Luke'S Hospital Grand View Campus

  • General Acute Care Hospital
  • Sellersville, PA
  • NPI 1568459287
  Care Compare affiliation
• Trustees of the University of Pennsylvania

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1851370910
  Care Compare affiliation

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1598719932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 789967",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191789967",
            "telephone_number": "484-622-7395",
            "fax_number": "484-622-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 SKIPPACK PIKE",
            "address_2": "SUITE 3",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221700",
            "telephone_number": "215-793-0600",
            "fax_number": "215-793-0759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUETKE",
        "first_name": "NICOLE",
        "middle_name": "K.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS012680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012761050001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC - PC/KHPE",
            "identifier": "2402357000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID#",
            "identifier": "11555034",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH/INTERCOUNTY",
            "identifier": "2402357000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30025600",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HMO/PPO",
            "identifier": "5855528",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7722728",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1735036",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1132437",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Simmonette Ponferrada Libre-Sabio, PT
• Nora J Lin, MD
• Hugh Lipshutz, MD
• Longevity100 Homecare Agency LLC
• Jennifer Anne Lorine, D.O.
• Joanne Marie Lynch, OTR/L
• Megan R Macdonnell, PSYD
• Marquita Mack, LICENSED PRACTICAL N
• Samuel Joseph Magliente, DC
• Marie Veronica Maguire, PA LCSW

• Family Medicine Physician in Blue Bell, PA
• Providers in Blue Bell, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.