Charles M. Lutz, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

T03108 Issued in MO

Practice address

1944 Zumbehl Rd
Saint Charles, MO 63303-2721

Phone

(636) 916-5367

Fax

(800) 432-6004

NPI assigned

Mar 20, 2006

Last updated

Dec 19, 2012By 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

Other identifiers 14

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nucrown, LLCGroup PAC ID 1456256346, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Nu-Crown, LLC

  dba Crown Optical

  • Optometrist
  • Alton, IL
  • NPI 1295737294

  MO

  Medicare reassignment Care Compare group NPD
• Paige Hedgpath OD,PC

  dba Eyes On Missouri

  • Optometrist
  • Jefferson City, MO
  • NPI 1962644732
  Medicare reassignment NPD
• Nucrown,Inc.

  dba Crown Optical

  • Optometrist
  • Saint Charles, MO
  • NPI 1114337102
  NPD
• Paige Hedgpath Odpc

  dba Eyes On Missouri

  • Optometrist
  • Columbia, MO
  • NPI 1669530887
  NPD

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1750340741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E BROADWAY",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026220",
            "telephone_number": "636-916-5367",
            "fax_number": "800-432-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1944 ZUMBEHL RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633032721",
            "telephone_number": "636-916-5367",
            "fax_number": "800-432-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "CHARLES",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "108615",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00403026",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MO",
            "identifier": "108615",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "44325",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "22-01201",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "314895202",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH PLANS",
            "identifier": "U90217",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "410048087",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "110972",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTICARE MED. COMPLETE",
            "identifier": "20990",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH PLAN",
            "identifier": "UNKNOWN",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA",
            "identifier": "20264",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "675482",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "314895210",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Lozano, LPC
• Alexandra Lucas, NP-C
• Dan William Luedke, MD
• Kailin Lynn Lust, OTD, OTR/L
• Lutheran Family & Children's Services of Mo
• Luxottica of America Inc (Target Optical #1927)
• Elizabeth Anne Lynch, APRN, DOC OF NURSING
• Sheila Kay Lynch, OTRL
• Gregory J Macdonnell, D.O.
• Luciana Jade Mach, PT, DPT

• Optometrist in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.