Individual provider Active NPI

Milycel Luna, SA-C

  • Surgical Assistant
  • Worcester, MA
National Provider Identifier
1073196820
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
19-312 Issued in WI
Practice address
547 Cambridge St Apt 1
Worcester, MA 01610-2673
Phone
(774) 778-4091
NPI assigned
Apr 29, 2021
Last updated
Apr 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 19-312 WI Primary

Addresses

Primary practice location

547 Cambridge St Apt 1
Worcester, MA 01610-2673

Mailing address

547 Cambridge St Apt 1
Worcester, MA 01610-2673
Phone (774) 778-4091

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
19-312WIMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1073196820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 CAMBRIDGE ST APT 1",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102673",
            "telephone_number": "774-778-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 CAMBRIDGE ST APT 1",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102673",
            "telephone_number": "774-778-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNA",
        "first_name": "MILYCEL",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "WI",
            "license": "19-312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.