Individual provider Active NPI

Ashley Marie Lutz, DO

  • Family Medicine Physician
  • Bogalusa, LA
National Provider Identifier
1922701614
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
W8593 Issued in TX
Practice address
420 Avenue F
Bogalusa, LA 70427-3634
Phone
(985) 730-6970
NPI assigned
Mar 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X W8593 TX Primary

Addresses

Primary practice location

420 Avenue F
Bogalusa, LA 70427-3634

Mailing address

3555 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 747-7675

Other practice location 1

3555 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 747-7675

Other identifiers 1

IdentifierTypeStateIssuer
2617095MedicaidLA

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20230628003534 LA Order and Referring Only - Family PracticePractitioner - Family Practice 4587023296

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: alutz5241580@direct.casso.us.com

NPI Registry JSON

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1922701614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 KNICKERBOCKER RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047610",
            "telephone_number": "325-747-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 AVENUE F",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704273634",
            "telephone_number": "985-730-6970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3555 Knickerbocker Rd",
            "address_purpose": "LOCATION",
            "city": "San Angelo",
            "state": "TX",
            "postal_code": "769047610",
            "country_code": "US",
            "telephone_number": "325-747-7675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "ASHLEY",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "W8593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2617095",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bogalusa, LA

Sources for this page

Verify at the official NPI Registry.