Individual provider Active NPI

Lucas Hyun

  • Physical Therapist
  • Ellicott City, MD
National Provider Identifier
1053808709
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305211735 Issued in VA
Practice address
10081 Colonial Dr
Ellicott City, MD 21042-6262
Phone
(443) 878-7273
NPI assigned
Apr 18, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305211735 VA Primary

Addresses

Primary practice location

10081 Colonial Dr
Ellicott City, MD 21042-6262

Mailing address

10081 Colonial Dr
Ellicott City, MD 21042-6262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2305211735VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1053808709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10081 COLONIAL DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210426262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10081 COLONIAL DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210426262",
            "telephone_number": "443-878-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYUN",
        "first_name": "LUCAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.