Individual provider Active NPI

Sharon Lee Lutosky, MD

  • Ophthalmology Physician
  • Modesto, CA
National Provider Identifier
1972592434
Registry record updated Jan 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G25184 Issued in CA
Practice address
1011 Sylvan Ave
Modesto, CA 95350-1692
Phone
(209) 575-2020
Fax
(209) 758-5693
NPI assigned
Oct 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G25184 CA Primary

Addresses

Primary practice location

1011 Sylvan Ave
Modesto, CA 95350-1692

Mailing address

1011 Sylvan Ave
Modesto, CA 95350-1692
Phone (209) 575-2020

Other identifiers 2

IdentifierTypeStateIssuer
00G251840MedicaidCA
180040074OtherRAILROAD MEDICARE

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

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296086400000",
    "number": "1972592434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 SYLVAN AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501692",
            "telephone_number": "209-575-2020",
            "fax_number": "209-758-5693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 SYLVAN AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501692",
            "telephone_number": "209-575-2020",
            "fax_number": "209-758-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTOSKY",
        "first_name": "SHARON",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2011-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G25184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G251840",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180040074",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; 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.