Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob Thomas Lutz, PHD

Individual provider Clinical Neuropsychologist · NPI 1164860052

Jacob Thomas Lutz, PHD is a Clinical Psychologist in Fort Wayne, Indiana. Qualified in 2012, 14 years ago. Practices with Fort Wayne Neuropsychology LLC, a 6-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Indiana.

Years since qualifying
14
Licensed in
IN
In the registry since
2013
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

11104 Parkview Circle Dr Ste 110
Fort Wayne, IN 46845-1673
Phone: (260) 460-3203
Fax: (260) 460-3271
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Neuropsychologist (primary) Taxonomy 103G00000X · Licence 20042679A (IN)

Record details

NPI number1164860052
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedJune 13, 2013
Last updated in NPPESJune 13, 2013
Mailing address11104 Parkview Circle Dr Ste 110, Fort Wayne, IN 46845-1673

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Fort Wayne Neuropsychology Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Fort Wayne