JACOB THOMAS LUTZ PHD
NPI 1164860052
Clinical Neuropsychologist in Fort Wayne, IN

NPI Status: Active since June 13, 2013

Contact Information

11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN
ZIP 46845
Phone: (260) 460-3203
Fax: (260) 460-3271

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  • Individual
  • Male
  • Years of Experience 14
  • Clinical Neuropsychologist
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JACOB LUTZ

This page provides the complete NPI Profile along with additional information for Jacob Lutz, a provider established in Fort Wayne, Indiana with a medical specialization in Clinical Neuropsychologist and more than 14 years of experience. The healthcare provider is registered in the NPI registry with number 1164860052 assigned on June 2013. The practitioner's primary taxonomy code is 103G00000X with license number 20042679A (IN). The provider is registered as an individual and his NPI record was last updated 12 years ago.

NPI
1164860052
Provider Name
JACOB THOMAS LUTZ PHD
Gender
Male
Entity Type
Individual
Location Address
11104 PARKVIEW CIRCLE DR STE 110 FORT WAYNE, IN 46845
Location Phone
(260) 460-3203
Location Fax
(260) 460-3271
Mailing Address
11104 PARKVIEW CIRCLE DR STE 110 FORT WAYNE, IN 46845
Mailing Phone
(260) 460-3203
Mailing Fax
(260) 460-3271
Medical School Name
OTHER
Graduation Year
2012
Is Sole Proprietor?
No
Enumeration Date
06-13-2013
Last Update Date
06-13-2013
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinical Neuropsychologist

Taxonomy Code
103G00000X
Type
Behavioral Health & Social Service Providers
License No.
20042679A
License State
IN
Taxonomy Description
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Clear Silver - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Central Bronze - HMO
  • Central Bronze + Vision + Adult Dental - HMO
  • Central Gold - HMO
  • Central Gold + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Bronze First 7500 $25 Generic Drugs - HMO
  • Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
  • Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
  • Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
  • Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Gold 1500 $15 Generic Drugs - HMO
  • Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
  • HDHP Preventive Silver 5500 $0 Select Drugs - HMO
  • Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
  • Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
  • Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • HSA Eligible Bronze 6000 - HMO
  • Low Premium Bronze 9200 $25 Generic Drugs - HMO
  • Low Premium Bronze 9200 $25 Generic Drugs Adult Vision & Fitness - HMO
  • Low Premium Silver 6000 $3 Generic Drugs - HMO
  • Low Premium Silver 6000 $3 Generic Drugs Adult Vision & Fitness - HMO
  • Platinum Zero $5 Generic Drugs - HMO
  • Platinum Zero $5 Generic Drugs Adult Vision & Fitness - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Jacob Lutz is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Jacob Lutz is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 6901040138

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20130910000253

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: No

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of psychological or neuropsychological test by technician, each additional 30 minutes

This service involves a technician administering additional psychological or neuropsychological testing. Each session lasts for an extra 30 minutes. These tests assess cognitive abilities, such as memory, attention, and problem-solving skills, to aid in diagnosing or monitoring mental health conditions.

This service was performed 470 times for 79 patients

Administration of psychological or neuropsychological test by technician, first 30 minutes

This procedure involves a trained technician administering a psychological or neuropsychological test. It's a process that assesses your mental function and behavior. The initial session will last 30 minutes. The aim is to understand your cognitive abilities better.

This service was performed 79 times for 79 patients

Evaluation of neuropsychological test, each additional hour

This service involves further evaluation of your neuropsychological test results beyond the initial hour. It helps to understand your cognitive functioning better, focusing on areas like memory, attention, and problem-solving skills.

This service was performed 80 times for 66 patients

Evaluation of neuropsychological test, first hour

An evaluation of neuropsychological tests is a process to assess your brain's function. It involves tasks designed to measure cognitive abilities such as memory, attention, problem-solving, and language skills. The first hour involves initial testing and observation.

This service was performed 83 times for 83 patients

Family psychotherapy with patient, 50 minutes

Family psychotherapy is a 50-minute session where a therapist helps the patient and their family understand and manage mental health issues. It's a collaborative process that aims to improve communication, solve family problems, understand and handle special family situations, and create a better functioning home environment.

This service was performed 12 times for 11 patients

Psychiatric diagnostic evaluation

A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.

This service was performed 104 times for 104 patients

Reviews for JACOB THOMAS LUTZ PHD

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1164860052
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
211241660010
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 1 + 2 + 4 + 1 + 6 + 6 + 0 + 0 + 1 + 0 + 24 = 48
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 48 = 22

The NPI number 1164860052 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1780681254 FRANCES R. GOFF PH.D.
Individual
Clinical Neuropsychologist11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 460-3100
1164938007 BRANDON EMRY
Individual
Nurse Practitioner11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780
1700043023DR. JASON M VOORHIES M.D.
Individual
Neurological Surgery11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780
1912965864DR. ELAINE CELESTE JONES MD
Individual
Psychiatry & Neurology (Neurology)11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780
1790780005 BRYAN DALE KAPLANSKY M.D.
Individual
Physical Medicine & Rehabilitation11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 373-5436
1346531282 LAUREN MAY KOFFMAN DO
Individual
Psychiatry & Neurology (Neurology)11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780
1275806663MRS. VIVIAN L APPIARIUS NP
Individual
Nurse Practitioner11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780
1831196237 JAMES C. DOZIER M.D.
Individual
Neurological Surgery11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780
1033651260 CAITLIN MARIE CAMP SHEEHAN APRN, AG-ACNP
Individual
Nurse Practitioner11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780
1114331493 TYLER ATKINS M.D.
Individual
Neurological Surgery11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780
1225321664DR. STEPHANIE R FALATKO D.O.
Individual
Neurological Surgery11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780
1275138364 CASSANDRA RAE RENTSCHLER
Individual
Nurse Practitioner11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780
1447495296 ERIN M. RICHMOND NP
Individual
Nurse Practitioner11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780
1508270810 AMBER R HETRICK M.D.
Individual
Psychiatry & Neurology (Neurology)11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780
1619325974 ERIC RYAN KIMMEL M.D.
Individual
Psychiatry & Neurology (Neurology)11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780
1659684488DR. SHAMIR HAJI M.D.
Individual
Psychiatry & Neurology (Neurocritical Care)11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780
1720726805 ALICIA F STOFFEL
Individual
Nurse Practitioner11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780
1750892675 CURTIS E LAKE
Individual
Physician Assistant11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780
1811105364 GUANGBIN XIA MD, PHD
Individual
Psychiatry & Neurology (Neurology)11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780
1912508169 BRYSON JAMES ROBUCK
Individual
Nurse Practitioner11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845
(260) 425-6780

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164860052, enumerated in the NPI registry as an "individual" on June 13, 2013

The provider is located at 11104 Parkview Circle Dr Ste 110 Fort Wayne, In 46845 and the phone number is (260) 460-3203

The provider's speciality is Clinical Neuropsychologist with taxonomy code 103G00000X

The provider has more than 14 years of experience.

The provider might be accepting Accepts: Ambetter from Meridian, Ambetter Health, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

The most common procedures or services performed by this practitioner are: Administration of psychological or neuropsychological test by technician, each additional 30 minutes, Administration of psychological or neuropsychological test by technician, first 30 minutes, Evaluation of neuropsychological test, each additional hour, Evaluation of neuropsychological test, first hour, Family psychotherapy with patient, 50 minutes and Psychiatric diagnostic evaluation.

This NPI record was last updated on June 13, 2013. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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