Thomas J Luetzow, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21500 Issued in WI

Practice address

145 N Main St
Fond Du Lac, WI 54935-3423

Phone

(920) 926-8492

NPI assigned

Aug 12, 2006

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Union Grove, WI
  • NPI 1245440601
  NPD (past)
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD (past)
• Emergency Medical Associates LLP

  • Emergency Medicine Physician
  • Waukesha, WI
  • NPI 1861483190
  NPD (past)
• Prohealth Medical Group Inc

  • Family Medicine Physician
  • Waukesha, WI
  • NPI 1790720613
  NPD (past)

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1598777419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-926-8340",
            "fax_number": "920-926-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 N MAIN ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353423",
            "telephone_number": "920-926-8492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUETZOW",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "21500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30483700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Africa Marquitia Lucas, SAC-IT
• Jennifer C. Lucas, P.T.
• Sarah J Luebke, RN
• Jody Lueck, LPN
• Angela C Luehring, M.S.
• Lumos
• Jack Lund
• Sheri Lund
• Breanne M Lundt
• Jackie Luthardt, MD

• Family Medicine Physician in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.