Individual provider Active NPI

Amanda K Lutter, NP

  • Gerontology Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1912322264
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
71004824A Issued in IN
Practice address
7411 Hope Dr Ste C
Fort Wayne, IN 46815-5687
Phone
(260) 234-5400
Fax
(260) 234-5395
NPI assigned
Feb 24, 2014
Last updated
Feb 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 71004824A IN
Gerontology Nurse Practitioner 363LG0600X 71004824A IN Primary

Addresses

Primary practice location

7411 Hope Dr Ste C
Fort Wayne, IN 46815-5687

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 432-2297

Other identifiers 2

IdentifierTypeStateIssuer
201214450MedicaidIN
IN4866027OtherINMEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address amanda.lutter@lutheranhealthnetwork.cernerdirect.com
Direct Messaging Address alutter@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140415001092 IN Practitioner - Nurse Practitioner 5092947523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Fort Wayne Physicians, LLC CurrentSince Dec 5, 2022 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Allied Physicians Inc PastSince Nov 1, 2022 Accepting new patients

Locations

256 E Pettit Ave
Ste 100
Fort Wayne, IN 46806

7411 Hope Dr
Ste C
Fort Wayne, IN 46815

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1912322264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7411 HOPE DR STE C",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468155687",
            "telephone_number": "260-234-5400",
            "fax_number": "260-234-5395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7916 W Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468044140",
            "country_code": "US",
            "telephone_number": "260-432-2297",
            "fax_number": "260-434-6433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTTER",
        "first_name": "AMANDA",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-24",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71004824A",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71004824A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201214450",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "IN4866027",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amanda.lutter@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "7916 W Jefferson Blvd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468044140",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alutter@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7411 Hope Dr Ste C",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468155687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.