Individual provider Active NPI

Samuel Elias Lucha, D.C.

  • Chiropractor
  • Saint Cloud, FL
National Provider Identifier
1043352669
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12276 Issued in FL
Practice address
1320 Louisiana Ave Ste D
Saint Cloud, FL 34769-4116
Phone
(407) 593-8052
Fax
(407) 593-9014
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH12276 FL Primary

Addresses

Primary practice location

1320 Louisiana Ave Ste D
Saint Cloud, FL 34769-4116

Mailing address

1320 Louisiana Ave Ste D
Saint Cloud, FL 34769-4116
Phone (407) 593-8052

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL luchachiropractic@gmail.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210427002829 FL Practitioner - Chiropractic 0547678765 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lucha Chiropractic Quality Center LLC Chiropractor CurrentSince Mar 1, 2021 Accepting new patients
Lucha Chiropractic, Inc. Past Accepting new patients

Locations

1320 Louisiana Ave
Ste D
Saint Cloud, FL 34769
Phone (407) 593-8052

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1043352669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 LOUISIANA AVE STE D",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347694116",
            "telephone_number": "407-593-8052",
            "fax_number": "407-593-9014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 LOUISIANA AVE STE D",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347694116",
            "telephone_number": "407-593-8052",
            "fax_number": "407-593-9014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCHA",
        "first_name": "SAMUEL",
        "middle_name": "ELIAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "luchachiropractic@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1320 Louisiana Ave Ste D",
            "city": "Saint Cloud",
            "state": "FL",
            "country_code": "US",
            "postal_code": "347694116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.