DR. DAVID J LUTZ (PH.D.) – Clinical Psychologist, NPI 1639166168

DR. DAVID J LUTZ (PH.D.) is a healthcare provider. based in Springfield, Missouri. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. R0201 (MO). The NPI Number for DR. DAVID J LUTZ (PH.D.) is 1639166168

Main info

Male
Sole Proprietor
46 Years Of Experience
Accepts Medicare Assignment
Name
DR. DAVID J LUTZ (PH.D.)
NPI
1639166168
Phone
(417) 882-4110
Address
1320 E KINGSLEY ST
Enumeration Date
30 September 2005
Last Update Date
15 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4175974625
Graduation Year
1980 (46 years ago)
PAC ID
3971795550
Professional Enrollment ID
I20221006001031
Address ID
KS662122555OV10555STXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:20State licenses:2Digital endpointsOther names

449 CLINICAL PSYCHOLOGIST in MO

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Provider Addresses for DR. DAVID J LUTZ (PH.D.)

  • 1320, East Kingsley Street, Springfield, Greene County, Missouri, 65804, United States

    SUITE A

    SPRINGFIELD, MO 658047216

    Phone: (417) 882-4110

    Fax: (417) 866-1496

    Type: Mailing

  • 7180 W 107TH ST STE 4

    OVERLAND PARK, KS 662122523

    Phone: (417) 597-4625

    Fax: (417) 866-1496

    Type: Mailing

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: 2022-10-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20101014000751IClinical PsychologistMOTBD
I20221006001031IClinical PsychologistKSTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 65804)

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Reviews

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Frequently asked questions

How do payers reference DR. DAVID J LUTZ (PH.D.)?
For DR. DAVID J LUTZ (PH.D.), use NPI 1639166168 as the unique 10-digit identifier.
Would DR. DAVID J LUTZ (PH.D.) appear as active to a payer?
You can treat DR. DAVID J LUTZ (PH.D.) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with DR. DAVID J LUTZ (PH.D.)?
DR. DAVID J LUTZ (PH.D.)'s record emphasizes Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Is DR. DAVID J LUTZ (PH.D.) located near Springfield?
DR. DAVID J LUTZ (PH.D.) currently maps to Springfield, Missouri in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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