Active NPI
Sharon Lee Lutosky, MD
- Ophthalmology Physician
- Modesto, CA
National Provider Identifier
1972592434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- G25184
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G251840 | Medicaid | CA | |
| 180040074 | Other | RAILROAD 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.