Individual provider Active NPI

Lucas McIntyre, MD

  • Child & Adolescent Psychiatry Physician
  • Tacoma, WA
National Provider Identifier
1043624240
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
MD60682919 Issued in WA
Practice address
316 S I St FL 1
Tacoma, WA 98405-4212
Phone
(253) 403-0556
NPI assigned
Jun 16, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X MD60682919 WA Primary

Addresses

Primary practice location

316 S I St FL 1
Tacoma, WA 98405-4212

Mailing address

316 S I St FL 1
Tacoma, WA 98405-4212
Phone (253) 403-0556

Other practice location 1

1959 NE Pacific St
Box 356560
Seattle, WA 98195-6560
Phone (206) 598-6190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20191126003082 WA Practitioner - Psychiatry 2668765892 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60682919WAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Oct 2, 2019 Accepting new patients
Multicare Health System CurrentSince Oct 2, 2019 Accepting new patients
Multicare Health System Current Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

Interoperability endpoints

  • Direct secure messaging: lmcintyre438772@direct.multicare.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.

NPI Registry JSON

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1043624240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 S I ST FL 1",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054212",
            "telephone_number": "253-403-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 S I ST FL 1",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054212",
            "telephone_number": "253-403-0556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1959 NE Pacific St",
            "address_2": "Box 356560",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981956560",
            "country_code": "US",
            "telephone_number": "206-598-6190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "LUCAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-16",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD60682919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.