DR. JEFFREY A. LUTY (MD) – General Practice Physician, NPI 1558442335
General Practice Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
45 GENERAL PRACTICE in OR
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Provider Addresses for DR. JEFFREY A. LUTY (MD)
17710, Southwest Vincent Street, Jersey Park, Huber, Aloha, Beaverton, Washington County, Oregon, 97078, United States
ALOHA, OR 970781782
Phone: (503) 314-4059
Type: Mailing
Rowe Creek Road, Twickenham, Wheeler County, Oregon, 97750, United States
WHEELER, OR 971470035
Phone: (503) 368-5182
Fax: (503) 368-5590
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: 2015-11-10
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20151110001506 | I | General Practice | OR | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 110 | 85 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 108 | 80 | $0 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 91 | 91 | $0 |
| 90480 | Admn sarscov2 vacc 1 dose | 91 | 91 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 30 | 30 | $0 |
Insurance plans in this area (ZIP 97078)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| GENERAL PRACTICE | OR | 85610 | Blood test, clotting time | 161 | 27 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | OR | |
| Nurse Practitioner | OR | |
| Nurse Practitioner | OR | |
| Nurse Practitioner | OR | |
| - | OR |
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