Amelia Luckow, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA64295 Issued in CA

Practice address

6719 Alvarado Rd Ste 308
San Diego, CA 92120-5268

Phone

(619) 265-7912

NPI assigned

Jun 21, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Jolla Spine Institute Medical Group IncGroup PAC ID 6608802806, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grossmont Hospital Hospital, La Mesa, CA, CCN 050026
• Palomar Health Downtown Campus Hospital, Escondido, CA, CCN 050115

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• La Jolla Spine Institute Medical Group, Inc.

  • Orthopaedic Surgery of the Spine Physician
  • San Diego, CA
  • NPI 1073677811
  Medicare reassignment Care Compare group
• United Medical Doctors

  • Gastroenterology Physician
  • Murrieta, CA
  • NPI 1770559981
  NPD (past)

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

• Grossmont Hospital Corporation

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  Care Compare affiliation
• Palomar Health

  • General Acute Care Hospital
  • Escondido, CA
  • NPI 1457321317
  Care Compare affiliation

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

{
    "created_epoch": "1718928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1063256360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6719 ALVARADO RD STE 308",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6719 ALVARADO RD STE 308",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205268",
            "telephone_number": "619-265-7912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKOW",
        "first_name": "AMELIA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-21",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "PA64295",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Thomas Luciano, PH.D.
• Domonique Lucio
• Simon Joseph Lucio, M.D.
• Sean William Luck
• Valencia Tatania Luckman, D.O.
• Lucks Psychology, Inc
• Bonnie D Lucks, PH.D
• Chloe Mae Lucksanalamai
• Luczynski Dental Corporation
• Paul Luczynski, D.D.S.

• Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.

Verify at the official NPI Registry.