LUCAN WATT CHATTERLEY (DO) – Family Medicine Physician, NPI 1053793489

LUCAN WATT CHATTERLEY (DO) is a healthcare provider. based in Grand rapids, Michigan. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. 5101022000 (MI). The NPI Number for LUCAN WATT CHATTERLEY (DO) is 1053793489

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
LUCAN WATT CHATTERLEY (DO)
NPI
1053793489
Phone
Not provided
Address
100 MICHIGAN ST NE # MC845
Enumeration Date
22 June 2015
Last Update Date
21 March 2023

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
6162524100
Graduation Year
2015 (11 years ago)
PAC ID
8325352131
Group Practice PAC ID
5597651836
Professional Enrollment ID
I20170829002309
Address ID
MI495482319WY781XXSEXX401

Contacts

FHIR Endpoint
https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/
Secure Messaging
lchatterley174569@epic00.shdirect.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness85
Years active:10State licenses:1Other namesUpdated within 12 months

4,418 FAMILY PRACTICE in MI

Provider Addresses for LUCAN WATT CHATTERLEY (DO)

  • 100 MICHIGAN ST NE # MC845

    GRAND RAPIDS, MI 495032560

    Phone:

    Type: Mailing

  • 4600 BRETON RD SE STE 102

    KENTWOOD, MI 495085220

    Phone: (616) 391-9700

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-08-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170829002309IFamily PracticeMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes5540$0
99214Established patient office or other outpatient visit, 30-39 minutes3220$0
View full utilization report →

Insurance plans in this area (ZIP 49503)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5597651836View full group profile
NameSpecialtyState
Internal MedicineMI
-MI
Nurse PractitionerMI
Physician AssistantMI
Hospitalist, Internal MedicineMI
-MI
Family PracticeMI
Physician AssistantMI
-MI
Physician AssistantMI

Reviews

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Frequently asked questions

What is the registry number for LUCAN WATT CHATTERLEY (DO)?
The registry entry for LUCAN WATT CHATTERLEY (DO) shows NPI 1053793489.
Is LUCAN WATT CHATTERLEY (DO) currently accepting referrals based on NPI status?
Registry metadata lists LUCAN WATT CHATTERLEY (DO) as active.
What does the directory say LUCAN WATT CHATTERLEY (DO) does?
Insurance directories may phrase it differently, but here LUCAN WATT CHATTERLEY (DO) maps to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to LUCAN WATT CHATTERLEY (DO)?
LUCAN WATT CHATTERLEY (DO) is associated with Grand Rapids, Michigan in the same public data insurers reference.
Who maintains LUCAN WATT CHATTERLEY (DO)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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