NPIMap

Individual provider Active NPI

Austin Mitchel Lutz, PA

  • Medical Physician Assistant
  • Marshall, MI
National Provider Identifier
1689325797
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1174 W Michigan Ave Ste B
Marshall, MI 49068-1625
Phone
(269) 789-4390
NPI assigned
Jan 11, 2022
Last updated
Nov 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MI Primary

Addresses

Primary practice location

1174 W Michigan Ave Ste B
Marshall, MI 49068-1625

Mailing address

3671 W E Ave
Kalamazoo, MI 49009-6329
Phone (269) 598-8540

Other practice location 1

4440 W Saginaw Hwy
Lansing, MI 48917-2701
Phone (517) 990-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220208000244 MI Practitioner - Physician Assistant 0941693337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ella E M Brown Charitable CircleGroup PAC ID 1254228745, 172 clinicians

Practice addresses (Care Compare)

200 N Madison St
Marshall, MI 49068-1143
Phone (269) 781-4271

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.06 of 100Reported as group
Quality
85.32
Promoting interoperability
100
Improvement activities
40
Cost
71.56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ella E M Brown Charitable Circle Physician Assistant CurrentSince Dec 5, 2022 Accepting new patients
Ella E M Brown Charitable Circle Medical CurrentSince Dec 5, 2022 Accepting new patients
Ella E M Brown Charitable Circle PastSince Nov 20, 2022 Accepting new patients
Lansing Urgent Care, PLC Past Accepting new patients

Locations

1174 W Michigan Ave
Ste B
Marshall, MI 49068
Phone (269) 789-4390

200 N Madison St
Marshall, MI 49068
Phone (269) 789-3921

Interoperability endpoints

  • Direct secure messaging: austin.lutz.1@9698.direct.athenahealth.com

Organizations & group practices 5

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 1

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": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1689325797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3671 W E AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490096329",
            "telephone_number": "269-598-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 W MICHIGAN AVE STE B",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490681625",
            "telephone_number": "269-789-4390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4440 W Saginaw Hwy",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489172701",
            "country_code": "US",
            "telephone_number": "517-990-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "AUSTIN",
        "middle_name": "MITCHEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, MI

Sources for this page

Verify at the official NPI Registry.