Individual provider Active NPI

Richard E Lutz, MD

  • Clinical Genetics (M.D.) Physician
  • Omaha, NE
National Provider Identifier
1992755326
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
21540 Issued in NE
Practice address
988102 Nebraska Medical Ctr
Omaha, NE 68198-8102
Phone
(402) 559-6402
Fax
(402) 559-5731
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X 21540 NE Primary

Addresses

Primary practice location

988102 Nebraska Medical Ctr
Omaha, NE 68198-8102

Mailing address

988102 Nebraska Medical Ctr
Omaha, NE 68198-8102
Phone (402) 559-6402

Other identifiers 1

IdentifierTypeStateIssuer
21540OtherNENE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20100324000557 NE Practitioner - Pediatric MedicinePractitioner - Endocrinology 4587799960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shenandoah Medical CenterGroup PAC ID 9436063237, shared by 7 NPIs, 52 clinicians

Practice addresses (Care Compare)

1 Jack Foster Dr
Shenandoah, IA 51601-4586
Phone (712) 246-7240

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Father Flanagan'S Boys' Home Clinical Genetics (M.D.) CurrentSince Nov 24, 2010 Accepting new patients

Locations

14080 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6900

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1992755326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102",
            "telephone_number": "402-559-6402",
            "fax_number": "402-559-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102",
            "telephone_number": "402-559-6402",
            "fax_number": "402-559-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "RICHARD",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "NE",
            "license": "21540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NE LICENSE",
            "identifier": "21540",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.