Active NPI
Michael Lee Lutter, MD
- Psychiatry Physician
- Plano, TX
National Provider Identifier
1710093844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- M0475
- Practice address
- 4716 Alliance Blvd #400
Plano, TX 75093 - Phone
- (972) 476-0800
- Fax
- (972) 596-1916
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | M0475 | TX | Primary |
| Psychiatry Physician | 2084P0800X | 40332 | IA |
Addresses
Primary practice location
4716 Alliance Blvd #400
Plano, TX 75093
Mailing address
4716 Alliance Blvd #400
Plano, TX 75093
Phone (972) 476-0800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2019 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40332 | IA | MD | Psychiatry Physician |
| M0475 | TX | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eating Recovery Center of Texas | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Eating Recovery Center of Ft. Worth
- Adult Mental Health Clinic/Center
- Fort Worth, TX
- NPI 1417446709
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487548800000",
"number": "1710093844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4716 ALLIANCE BLVD #400",
"city": "PLANO",
"state": "TX",
"postal_code": "75093",
"telephone_number": "972-476-0800",
"fax_number": "972-596-1916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4716 ALLIANCE BLVD #400",
"city": "PLANO",
"state": "TX",
"postal_code": "75093",
"telephone_number": "972-476-0800",
"fax_number": "972-596-1916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTTER",
"first_name": "MICHAEL",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2017-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "M0475",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IA",
"license": "40332",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.