Justyn Lutfy, MD CM, FRCS(C)

Primary specialty

Surgery of the Hand (Surgery) PhysicianTaxonomy code 2086S0105X

License

125.066416 Issued in IL

Practice address

747 N Rutledge St
Springfield, IL 62702-6700

Phone

(217) 545-6112

Fax

(217) 545-2588

NPI assigned

Jul 15, 2015

Last updated

Jul 15, 2015By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1629452073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19653",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949653",
            "telephone_number": "217-545-6112",
            "fax_number": "217-545-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 N RUTLEDGE ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627026700",
            "telephone_number": "217-545-6112",
            "fax_number": "217-545-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTFY",
        "first_name": "JUSTYN",
        "name_prefix": "Dr.",
        "credential": "MD CM, FRCS(C)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-15",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "IL",
            "license": "125.066416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery of the Hand (Surgery) Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Surgery of the Hand (Surgery) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.