Individual provider Active NPI

Kurtis Alan Lucas, MD

  • Family Medicine Physician
  • Waterloo, IA
National Provider Identifier
1003267147
Registry record updated Jun 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R10730 Issued in IA
Practice address
2055 Kimball Ave Ste 101
Waterloo, IA 50702-5047
Phone
(319) 272-2112
Fax
(319) 272-2107
NPI assigned
Jun 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R10730 IA Primary

Addresses

Primary practice location

2055 Kimball Ave Ste 101
Waterloo, IA 50702-5047

Mailing address

2055 Kimball Ave Ste 101
Waterloo, IA 50702-5047
Phone (319) 272-2112

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180228000700 IA Practitioner - Family PracticePractitioner - Hospitalist 2769776400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
University of Oklahoma College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

1825 Logan Ave
Waterloo, IA 50703-1916
Phone (319) 235-3941

Hospital & facility affiliations

  • Allen Hospital Hospital, Waterloo, IA, CCN 160110
  • Grundy County Memorial Hospital Hospital, Grundy Center, IA, CCN 161303
  • Unitypoint Health - Marshalltown Hospital, Marshalltown, IA, CCN 160001
  • Waverly Health Center Hospital, Waverly, IA, CCN 161339
  • Community Memorial Hospital Medical Center Hospital, Sumner, IA, CCN 161320

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R10730IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation Family Medicine CurrentSince Sep 16, 2019 Accepting new patients
Allen Memorial Hospital Corporation Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

1825 Logan Ave
Waterloo, IA 50703
Phone (319) 235-3886

1825 Logan Ave
Ste 201
Waterloo, IA 50703

Interoperability endpoints

  • Direct secure messaging: klucas417422@direct.unitypoint.org

Organizations & group practices 3

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

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1003267147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 KIMBALL AVE STE 101",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025047",
            "telephone_number": "319-272-2112",
            "fax_number": "319-272-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 KIMBALL AVE STE 101",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025047",
            "telephone_number": "319-272-2112",
            "fax_number": "319-272-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "KURTIS",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R10730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.