Lorenzen Lucas

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA54129 Issued in CA

Practice address

600 B St
Livingston, CA 95334-9593

Phone

(209) 850-3500

NPI assigned

Dec 8, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lorenzen.lucas.p3@direct.livingstoncommunity.nextgenshare.com

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.

• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Livingston, CA
  • NPI 1427110329
  Medicare reassignment
• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Hilmar, CA
  • NPI 1124300207
  NPD
• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1649099151
  NPD
• Lumira Healthcare

  • Community/Retail Pharmacy
  • Livingston, CA
  • NPI 1073175675
  NPD (past)
• Diagnostic Pro Imaging

  • Diagnostic Radiology Physician
  • El Paso, TX
  • NPI 1346777190
  NPD (past)

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1073911087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 B ST BLDG A",
            "city": "LIVINGSTON",
            "state": "CA",
            "postal_code": "953349593",
            "telephone_number": "209-850-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 B ST",
            "city": "LIVINGSTON",
            "state": "CA",
            "postal_code": "953349593",
            "telephone_number": "209-850-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6974 Gateway Blvd E",
            "address_2": "Suite F",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799151118",
            "country_code": "US",
            "telephone_number": "915-774-8850",
            "fax_number": "915-598-3946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "LORENZEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-08",
        "last_updated": "2021-03-11",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09585",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA54129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "PA09585",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "346983501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Livingston Community Health
• Livingston Community Health Services
• Livingston Union Elementary
• Muoi Loi, PA-C
• Laura Lilia Lopez, FNP-C
• Lumira Healthcare
• Lumira Healthcare
• Lumira Healthcare
• Hortensia Maldonado
• Prubjot Malhi

• Physician Assistant in Livingston, CA
• Providers in Livingston, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.