Candida Jane Lutes, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

21711 Issued in TX

Practice address

3500 Oak Lawn Ave.
Suite 275
Dallas, TX 75219-4308

Phone

(214) 522-0498

Fax

(214) 522-0454

NPI assigned

Jul 11, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Southern Illinois University School of Medicine, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1952309395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 OAK LAWN AVE.",
            "address_2": "SUITE 275",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194308",
            "telephone_number": "214-522-0498",
            "fax_number": "214-522-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 OAK LAWN AVE.",
            "address_2": "SUITE 275",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194308",
            "telephone_number": "214-522-0498",
            "fax_number": "214-522-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTES",
        "first_name": "CANDIDA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-11",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "21711",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "21711",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00334369-01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0334379-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deanna L Lusty, PT, MPT, ATP/SMS
• Kazia Maria Luszczynska, M.D.
• Bryce Alexander Lutan, MD
• Cynthia Luter, PA-C
• David L Luterman, M.D.
• Lutheran Counseling Services
• Ann E Lutich
• Lucas Luttrell, RN
• Steven Reece Luttrell, CRNA
• Edward Grant Lutz, DDS

• Clinical Neuropsychologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Neuropsychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.