NPIMap

Individual provider Active NPI

Dustin Dean Lucarelli, MD

  • Surgery Physician
  • Duluth, MN
National Provider Identifier
1003170424
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
62251 Issued in MN
Practice address
920 E 1St St Ste P302
Duluth, MN 55805-2201
Phone
(218) 262-4881
NPI assigned
Jun 29, 2012
Last updated
Dec 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 62251 MN Primary

Addresses

Primary practice location

920 E 1St St Ste P302
Duluth, MN 55805-2201

Mailing address

920 E 1St St Ste P302
Duluth, MN 55805-2201

Other practice location 1

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-9222

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170713001766 MN Practitioner - General Surgery 4789815440 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke's Hospital of DuluthGroup PAC ID 7113834839, 409 clinicians

Practice addresses (Care Compare)

920 E 1St St
Suite 302
Duluth, MN 55805-2225
Phone (218) 249-6050

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy14
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
62251MNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital of Duluth CurrentSince Jul 1, 2020 Accepting new patients
Range Regional Health Services CurrentSince Jul 1, 2017 Accepting new patients
Range Regional Health Services Current Accepting new patients
Range Regional Health Services CurrentSince Jul 1, 2017 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Jul 1, 2020 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
St. Luke's Hospital of Duluth Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

920 E 1st St
Ste 302
Duluth, MN 55805
Phone (218) 249-6050

920 E 1st St
Ste P302
Duluth, MN 55805
Phone (218) 249-6050

1814 14th Ave E
Hibbing, MN 55746
Phone (218) 262-3441

3605 Mayfair Ave
Hibbing, MN 55746
Phone (218) 262-3441

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

4791 County Road 10
Moose Lake, MN 55767
Phone (218) 249-5357

402 E Platt Ave
Nashwauk, MN 55769
Phone (218) 885-2858

Interoperability endpoints

  • Direct secure messaging: dlucarelli237496@direct.aspirus.org
  • Direct secure messaging: dustin.lucarelli@slk.direct.slhduluth.com
  • Direct secure messaging: him@slk.direct.slhduluth.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 33

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 33

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1003170424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 E 1ST ST STE P302",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 E 1ST ST STE P302",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052201",
            "telephone_number": "218-262-4881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 N Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Marshfield",
            "state": "WI",
            "postal_code": "544495703",
            "country_code": "US",
            "telephone_number": "715-387-9222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCARELLI",
        "first_name": "DUSTIN",
        "middle_name": "DEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-29",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "62251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "920 E 1st St Ste P302",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558052201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.