Individual provider Active NPI

Steven P Lutz, O.D.

  • Optometrist
  • Ann Arbor, MI
National Provider Identifier
1831159268
Registry record updated Oct 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002919 Issued in MI
Practice address
1565 Eastover Place
Ann Arbor, MI 48104
Phone
(734) 769-2909
Fax
(734) 929-4142
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901002919 MI Primary

Addresses

Primary practice location

1565 Eastover Place
Ann Arbor, MI 48104

Mailing address

1565 Eastover Place
Ann Arbor, MI 48104
Phone (734) 769-2909

Other identifiers 3

IdentifierTypeStateIssuer
0H16509OtherBLUE CROSS
4829010MedicaidMI
900H165090OtherBLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20050228000752 MI Practitioner - Optometry 1658324827 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Steven Lutz and Associates PCGroup PAC ID 6204889470, 2 clinicians

Practice addresses (Care Compare)

1565 Eastover PL
Ann Arbor, MI 48104-6316
Phone (734) 769-2909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Robert T Clark MD PC Optometrist CurrentSince Jun 25, 2015 Accepting new patients

Locations

7329 Grand River Rd
Brighton, MI 48114
Phone (810) 474-3937

Organizations & group practices 2

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1831159268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 EASTOVER PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48104",
            "telephone_number": "734-769-2909",
            "fax_number": "734-929-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 EASTOVER PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48104",
            "telephone_number": "734-769-2909",
            "fax_number": "734-929-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "STEVEN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0H16509",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4829010",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "900H165090",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.