Individual provider Active NPI

Terry Francis Lutz, O.D.

  • Corneal and Contact Management Optometrist
  • Utica, NY
National Provider Identifier
1780731398
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
3819 Issued in NY
Practice address
710 Horatio St Unit Z4
Vision Center
Utica, NY 13502-1400
Phone
(315) 733-7339
Fax
(315) 849-2166
NPI assigned
Jan 4, 2007
Last updated
Jul 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 3819 NY Primary

Addresses

Primary practice location

710 Horatio St Unit Z4
Vision Center
Utica, NY 13502-1400

Mailing address

710 Horatio St Unit Z4
Vision Center
Utica, NY 13502-1400
Phone (315) 733-7339

Other identifiers 1

IdentifierTypeStateIssuer
00725860MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20050718000653 NY Practitioner - Optometry 8426084963 Practice locations: Utica, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3819NYMDCorneal and Contact Management Optometrist
003819NYMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1780731398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 HORATIO ST UNIT Z4",
            "address_2": "VISION CENTER",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135021400",
            "telephone_number": "315-733-7339",
            "fax_number": "315-849-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 HORATIO ST UNIT Z4",
            "address_2": "VISION CENTER",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135021400",
            "telephone_number": "315-733-7339",
            "fax_number": "315-849-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "TERRY",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NY",
            "license": "3819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00725860",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.