Individual provider Active NPI

Kristin E Lutz

  • Nurse Practitioner
  • Annapolis, MD
National Provider Identifier
1639826852
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R271561 Issued in MD
Practice address
116 Defense Hwy Ste 400
Annapolis, MD 21401-7050
Phone
(410) 897-9841
Fax
(410) 897-9852
NPI assigned
Mar 8, 2022
Last updated
Feb 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R271561 MD Primary
Family Nurse Practitioner 363LF0000X AC004201 AL
Family Nurse Practitioner 363LF0000X 0024183900 VA

Addresses

Primary practice location

116 Defense Hwy Ste 400
Annapolis, MD 21401-7050

Mailing address

429 Maple Leaf Dr
Edgewater, MD 21037-3207
Phone (407) 432-7390

Other identifiers 1

IdentifierTypeStateIssuer
R271561OtherMDLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20220609000579 MD Practitioner - Nurse Practitioner 7618355223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Annapolis Internal Medicine, LLCGroup PAC ID 2163324997, 22 clinicians

Practice addresses (Care Compare)

116 Defense Hwy
Suite 400
Annapolis, MD 21401-7050
Phone (410) 897-9841

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R271561MDMDNurse Practitioner
AC004201ALMDFamily Nurse Practitioner
0024183900VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Annapolis Internal Medicine, LLC CurrentSince Sep 21, 2022 Accepting new patients
Titus C. Abraham, MD, LLC Past Accepting new patients

Locations

116 Defense Hwy
Ste 400
Annapolis, MD 21401
Phone (410) 897-9841

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3805/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kristin.lutz.1@3805.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1639826852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 MAPLE LEAF DR",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210373207",
            "telephone_number": "407-432-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 DEFENSE HWY STE 400",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017050",
            "telephone_number": "410-897-9841",
            "fax_number": "410-897-9852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "KRISTIN",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-08",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R271561",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "AC004201",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024183900",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "R271561",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.