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DR. ALEXANDRIA LYNN LUTLEY M.D.
NPI 1699036129
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in Fort Worth, TX

Active since May 31, 2012PECOS EnrolledAccepts Medicare Assignment
1500 COOPER ST, FORT WORTH, TX 76104(682) 885-2500 Get Directions Write a Review

NPPES record last updated: November 2, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Nov 2, 2022, Jul 21, 2022, Jul 20, 2017 and 2 more (5 updates tracked since 2015).

About Dr. Alexandria Lynn Lutley M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ALEXANDRIA LYNN LUTLEY M.D. (NPI 1699036129) is an individual neurology with special qualifications in child neurology provider in Fort Worth, Texas, licensed in Texas (T9736) and active in the NPI registry since May 2012. She is enrolled in Medicare PECOS and is a graduate of University Of Connecticut School Of Medicine (2012).

NPPES Registry Identity

NPI1699036129
Entity TypeIndividualFemale
Primary Taxonomy2084N0402X
Provider Legal NameDR. ALEXANDRIA LYNN LUTLEYCredential: M.D.
Location Address1500 COOPER STFort Worth, TX 76104-2710
Mailing AddressPo Box 733784Dallas, TX 75373-3784 · (682) 885-6483 · Fax (682) 885-3113
Phone(682) 885-2500
Sole ProprietorNo
Medical School CMSUniversity Of Connecticut School Of MedicineGraduated 2012
Enumeration DateMay 31, 2012
Last NPPES UpdateNovember 2, 20225 updates tracked since enumeration
NPPES CertifiedNovember 2, 2022
✔ NPI 1699036129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Neurology with Special Qualifications in Child NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0402X
License✔ Licensed in TX · T9736
Definition
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
1500 COOPER ST, Fort Worth, TX 76104
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Baylor Scott and White Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Alexandria Lynn Lutley M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7012274830
PECOS Enrollment IDI20221026002967
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$129.63 typical visit price
range $56.47 – $171.07
Typical copayment $32.40 (range $14.11 – $42.76)
Most-billed visit code 99204
Established Patient
$99.68 typical visit price
range $18.18 – $139.68
Typical copayment $24.92 (range $4.54 – $34.92)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATRINA L WILLIE-MUSOMA MD
Pediatrics (Neurodevelopmental Disabilities)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 303-9300
SCHARLYN R HENDERSON LCSW
Social Worker (Clinical)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-1475
GREGORY BARKER
Pediatrics (Pediatric Cardiology)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-2140
DR. ELORA PATTANAIK CORBIN M.D.
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-2500
SHANE KELLEHER PA-C
Physician Assistant
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-7840
BENJAMIN CRAIG PA-C
Physician Assistant
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-2500
DR. SHAILENDRA DAS D.O.
Pediatrics (Pediatric Pulmonology)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-6299
JAMES C CUNNINGHAM MD
Pediatrics (Pediatric Pulmonology)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-6299

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alexandria Lutley's NPI number?

The NPI number for Alexandria Lutley is 1699036129. It was assigned to this individual provider in the NPPES registry on May 31, 2012.

Where is Alexandria Lutley located?

Alexandria Lutley practices at 1500 Cooper St, Fort Worth, TX 76104. The listed phone number is (682) 885-2500.

What is Alexandria Lutley's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology with Special Qualifications in Child Neurology, with taxonomy code 2084N0402X.

Is Alexandria Lutley enrolled in Medicare?

Yes. Alexandria Lutley is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Alexandria Lutley accept?

Health plans from Baylor Scott and White Health Plan list Alexandria Lutley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Alexandria Lutley was last updated on November 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.