Jeanine Lutgen, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

3608 Issued in AZ

Practice address

4521 W Hopi TRL
Laveen, AZ 85339-2068

Phone

(602) 795-3371

NPI assigned

Dec 11, 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 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Physician Assistant

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner Physician Specialists Arizona LLCGroup PAC ID 6204002272, 371 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089

Merit-based Incentive Payment System (MIPS)

Final score

84.12 of 100Reported as group

Quality

76.35

Promoting interoperability

99

Improvement activities

40

Cost

71.55

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1821368218

  AZ

  Medicare reassignment Care Compare group NPD
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Chandler, AZ
  • NPI 1063260909
  Care Compare group
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Glendale, AZ
  • NPI 1073295036
  Care Compare group
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Queen Creek, AZ
  • NPI 1477301364
  Care Compare group
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Sun City West, AZ
  • NPI 1548538069
  Care Compare group
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Peoria, AZ
  • NPI 1588933139
  Care Compare group
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Glendale, AZ
  • NPI 1821846726
  Care Compare group
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Gilbert, AZ
  • NPI 1861249740
  Care Compare group
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Surprise, AZ
  • NPI 1972351815
  Care Compare group
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Peoria, AZ
  • NPI 1992073498
  Care Compare group
• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1316228802
  NPD
• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Page, AZ
  • NPI 1366799355
  NPD

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

• Banner Thunderbird Medical Center

  • General Acute Care Hospital
  • Glendale, AZ
  • NPI 1154355188

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1609936772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 436",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853390436",
            "telephone_number": "602-795-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4521 W HOPI TRL",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853392068",
            "telephone_number": "602-795-3371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6750 E Baywood Ave",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852061749",
            "country_code": "US",
            "telephone_number": "480-854-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5555 W Thunderbird Rd",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853064622",
            "country_code": "US",
            "telephone_number": "602-865-5555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1955 W Frye Rd",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852246282",
            "country_code": "US",
            "telephone_number": "489-728-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9201 W Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850373332",
            "country_code": "US",
            "telephone_number": "623-327-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10401 W Thunderbird Blvd",
            "address_purpose": "LOCATION",
            "city": "Sun City",
            "state": "AZ",
            "postal_code": "853513004",
            "country_code": "US",
            "telephone_number": "623-997-7211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13677 W McDowell Rd",
            "address_purpose": "LOCATION",
            "city": "Goodyear",
            "state": "AZ",
            "postal_code": "853952635",
            "country_code": "US",
            "telephone_number": "623-882-1500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18701 N 67th Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853087100",
            "country_code": "US",
            "telephone_number": "623-561-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1930 E Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850167711",
            "country_code": "US",
            "telephone_number": "602-532-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 S Dobson Rd",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024707",
            "country_code": "US",
            "telephone_number": "480-512-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTGEN",
        "first_name": "JEANINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "3608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "284600",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Laveen, AZ
• Surgical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; 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.