Individual provider Active NPI

Andrew Gardner Lutz, MD

  • Anesthesiology Physician
  • Raleigh, NC
National Provider Identifier
1699789800
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Practice address
3000 New Bern Ave
Raleigh, NC 27610-1231
Phone
(919) 350-5645
NPI assigned
Jul 27, 2006
Last updated
Jan 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NC Primary

Addresses

Primary practice location

3000 New Bern Ave
Raleigh, NC 27610-1231

Mailing address

4101 N Roxboro St
Durham, NC 27704-2121
Phone (919) 684-8111

Other identifiers 6

IdentifierTypeStateIssuer
5904432MedicaidNC
199318OtherNCMEDCOST
5025563OtherNCCIGNA
809945OtherNCPARTNERS
142Y3OtherNCBCBS
P00409583OtherNCRAILRAOD-MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060927000545 NC Practitioner - Anesthesiology 2961407846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Pennsylvania State University College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone (919) 784-3034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2006-00746NCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of North Carolina, PLLC Anesthesiology Current Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Jul 23, 2007 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Jul 23, 2007 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology Past Accepting new patients

Locations

11200 Governor Manly Way
Ste 110
Raleigh, NC 27614
Phone (919) 570-5900

23 Sunnybrook Rd
Ste 100
Raleigh, NC 27610
Phone (919) 322-4800

2308 Wesvill Ct
Raleigh, NC 27607
Phone (919) 278-7762

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

3001 Edwards Mill Rd
#100
Raleigh, NC 27612
Phone (919) 719-3070

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200355200000",
    "number": "1699789800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042121",
            "telephone_number": "919-684-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101231",
            "telephone_number": "919-350-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "ANDREW",
        "middle_name": "GARDNER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2008-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904432",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "199318",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5025563",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "809945",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "142Y3",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILRAOD-MEDICARE",
            "identifier": "P00409583",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.