Active NPI
Caroline Luczak
- Physician Assistant
- Mountain View, CA
National Provider Identifier
1053960724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 2490 Hospital Dr Ste 211
Mountain View, CA 94040-4125 - Phone
- (650) 988-7488
- NPI assigned
- Sep 5, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
2490 Hospital Dr Ste 211
Mountain View, CA 94040-4125
Mailing address
2490 Hospital Dr Ste 211
Mountain View, CA 94040-4125
Phone (650) 988-7488
Other practice location 1
2902 Westwood Estates Dr
Erie, PA 16506-5606
Phone (814) 602-2134
Other practice location 2
88 E San Fernando St
San Jose, CA 95113-2535
Phone (814) 602-2134
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210111001799 | CA | Practitioner - Physician Assistant | 3375956493 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Livwell Healthcare Solutions PCEl Camino Health Medical Network LLC
Practice addresses (Care Compare)
594 El Camino Real
Santa Clara, CA 95050-4345
Phone (408) 821-4449
815 Pollard Rd
Los Gatos, CA 95032-1438
Phone (408) 866-4070
Hospital & facility affiliations
- El Camino Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57338 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bass Medical Group | Past | Accepting new patients | |
| El Camino Health Medical Group | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Obstetrics & Gynecology Physician
- Walnut Creek, CA
- NPI 1174253405
-
- Geriatric Medicine (Family Medicine) Physician
- Los Gatos, CA
- NPI 1578831764
Hospital & facility affiliations 3
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": "1567641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740528000000",
"number": "1053960724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2490 HOSPITAL DR STE 211",
"city": "MOUNTAIN VIEW",
"state": "CA",
"postal_code": "940404125",
"telephone_number": "650-988-7488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2490 HOSPITAL DR STE 211",
"city": "MOUNTAIN VIEW",
"state": "CA",
"postal_code": "940404125",
"telephone_number": "650-988-7488"
}
],
"practiceLocations": [
{
"address_1": "2902 Westwood Estates Dr",
"address_purpose": "LOCATION",
"city": "Erie",
"state": "PA",
"postal_code": "165065606",
"country_code": "US",
"telephone_number": "814-602-2134",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "88 E San Fernando St",
"address_purpose": "LOCATION",
"city": "San Jose",
"state": "CA",
"postal_code": "951132535",
"country_code": "US",
"telephone_number": "814-602-2134",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LUCZAK",
"first_name": "CAROLINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-05",
"last_updated": "2025-02-26",
"certification_date": "2025-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain View, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.