Individual provider Active NPI

Adam Khoa Lu, DPM

  • Foot Surgery Podiatrist
  • Phoenix, AZ
National Provider Identifier
1083617781
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
POD-000916 Issued in AZ
Practice address
16423 S 34TH Way
Phoenix, AZ 85048-7871
Phone
(480) 518-1468
NPI assigned
May 27, 2005
Reactivated
Mar 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X POD-000916 AZ Primary

Addresses

Primary practice location

16423 S 34TH Way
Phoenix, AZ 85048-7871

Mailing address

16423 S 34TH Way
Phoenix, AZ 85048-7871
Phone (480) 518-1468

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
940GAMDClinical Psychologist
0572AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Casa Grande Foot & Ankle Spec PastSince Jan 20, 2005 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1083617781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16423 S 34TH WAY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487871",
            "telephone_number": "480-518-1468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16423 S 34TH WAY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487871",
            "telephone_number": "480-518-1468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LU",
        "first_name": "ADAM",
        "middle_name": "KHOA",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2018-10-24",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "AZ",
            "license": "POD-000916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.