Darlene S Lutchka, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036112428 Issued in IL

Practice address

400 S Lewis Lane
Carbondale, IL 62901-1409

Phone

(618) 519-9900

Fax

(518) 519-9901

NPI assigned

Jun 2, 2006

Last updated

Dec 11, 2020By the provider in NPPES

Sex

Female

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 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Family Practice

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shawnee Health Service and Development CorpGroup PAC ID 1658285671, 51 clinicians

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164
• Herrin Hospital Hospital, Herrin, IL, CCN 140011
• St Joseph Memorial Hospital Hospital, Murphysboro, IL, CCN 141334

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: darlene.lutchka.1@14668.direct.athenahealth.com

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.

• Shawnee Health Service and Development Corp

  • Federally Qualified Health Center (FQHC)
  • Carterville, IL
  • NPI 1639295314

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Shawnee Health Service and Development Corp

  dba Shawnee Health Care, Murphysboro

  • Federally Qualified Health Center (FQHC)
  • Murphysboro, IL
  • NPI 1245260645

  Family Medicine

  NPD
• Shawnee Health Service and Development Corp

  dba Shawnee Health Pharmacy Carbondale

  • Community/Retail Pharmacy
  • Carbondale, IL
  • NPI 1760253447
  NPD
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• Shawnee Health Service and Development Corp

  dba Shawnee Health Care, Carbondale

  • Federally Qualified Health Center (FQHC)
  • Carbondale, IL
  • NPI 1073745345

  Family Medicine

  NPD (past)

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

• Southern Illinois Hospital Services

  dba Memorial Hospital of Carbondale

  • General Acute Care Hospital
  • Carbondale, IL
  • NPI 1093801797
  Care Compare affiliation
• Southern Illinois Hospital Services

  dba St. Joseph Memorial Hospital

  • Critical Access Hospital
  • Murphysboro, IL
  • NPI 1356435135
  Care Compare affiliation
• Southern Illinois Hospital Services

  dba Herrin Hospital

  • General Acute Care Hospital
  • Herrin, IL
  • NPI 1528158573
  Care Compare affiliation

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1760429146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 577",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629180577",
            "telephone_number": "618-985-8221",
            "fax_number": "618-985-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S LEWIS LANE",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011409",
            "telephone_number": "618-519-9900",
            "fax_number": "518-519-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTCHKA",
        "first_name": "DARLENE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036112428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370966854017",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112428",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD GROUP",
            "identifier": "CF3444",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "darlene.lutchka.1@14668.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "400 S Lewis Lane",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Alan Longmire
• Alexis Elizabeth Lorinskas, PA-C
• Deandre Love
• Robert E Lowry, LCPC
• Kellie J Lustenberger, N.P.
• William Lyman
• Mary C Lyons, PA
• Emily Margaret Macdonald
• Allison Magnuson, MD
• Zubin Ajay Mahajan, M.D.

• Family Medicine Physician in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.