Individual provider Active NPI

Nancy R. Lutwak, M.D.

  • Emergency Medicine Physician
  • Elmhurst, NY
National Provider Identifier
1801973680
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
164719 Issued in NY
Practice address
9002 Queens Blvd
Elmhurst, NY 11373-4941
Phone
(718) 558-1733
Fax
(718) 558-1702
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 164719 NY Primary

Addresses

Primary practice location

9002 Queens Blvd
Elmhurst, NY 11373-4941

Mailing address

158 W 27TH St
11TH Floor South
New York, NY 10001-6216
Phone (212) 563-2497

Other identifiers 1

IdentifierTypeStateIssuer
01265952MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
164719NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caritas Emergency Medical Services, PC Emergency Medicine Past Accepting new patients
CMC Radiological Services PC Past Accepting new patients
Caritas Emergency Medical Services, PC Emergency Medicine Past Accepting new patients
CMC Radiological Services PC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1801973680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 W 27TH ST",
            "address_2": "11TH FLOOR SOUTH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016216",
            "telephone_number": "212-563-2497",
            "fax_number": "212-563-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9002 QUEENS BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734941",
            "telephone_number": "718-558-1733",
            "fax_number": "718-558-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTWAK",
        "first_name": "NANCY",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "164719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01265952",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.