NPIMap

Individual provider Active NPI

Lucas Taylor Edelen, MD

  • Family Medicine Physician
  • Danville, KY
National Provider Identifier
1093218828
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
58308 Issued in KY
Practice address
109 Daniel Drive
Danville, KY 40422-3543
Phone
(859) 236-3361
NPI assigned
Mar 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 58308 KY Primary

Addresses

Primary practice location

109 Daniel Drive
Danville, KY 40422-3543

Mailing address

109 Daniel Drive
Danville, KY 40422

Other practice location 1

500 S Preston St Rm 305
Louisville, KY 40202-1702
Phone (502) 852-8696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230718003808 KY Practitioner - Family Practice 4385048297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ephraim McDowell Health Resource IncGroup PAC ID 7517876956, 161 clinicians

Practice addresses (Care Compare)

109 Daniel Dr
Danville, KY 40422-2527
Phone (859) 236-3361

Hospital & facility affiliations

  • McDowell Home Health Agency Home health agency, Danville, KY, CCN 187040
  • Centerwell Home Health Home health agency, Danville, KY, CCN 187183
  • Ephraim McDowell Fort Logan Hospital Hospital, Stanford, KY, CCN 181315
  • Ephraim McDowell Regional Medical Center Hospital, Danville, KY, CCN 180048
  • The James B. Haggin Memorial Hospital Hospital, Harrodsburg, KY, CCN 181302

Merit-based Incentive Payment System (MIPS)

Final score
81.36 of 100Reported as group
Quality
64.78
Promoting interoperability
100
Improvement activities
40
Cost
67.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
58308KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ephraim McDowell Health Resource, Inc Family Medicine CurrentSince Jul 5, 2023 Accepting new patients
Ephraim McDowell Health Resource, Inc. Family Medicine CurrentSince Jul 5, 2023 Accepting new patients
Ephraim McDowell Regional Medical Center Incorporated Family Medicine Past Accepting new patients

Locations

109 Daniel Dr
Danville, KY 40422
Phone (859) 236-3361

2195 Harrodsburg Rd
Ste 125
Lexington, KY 40504
Phone (859) 257-4732

2195 Harrodsburg Rd
Lexington, KY 40504
Phone (859) 323-2232

Organizations & group practices 3

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.

Hospital & facility affiliations 11

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": "1521331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1093218828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 DANIEL DRIVE",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "40422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 DANIEL DRIVE",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404223543",
            "telephone_number": "859-236-3361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 S Preston St Rm 305",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021702",
            "country_code": "US",
            "telephone_number": "502-852-8696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDELEN",
        "first_name": "LUCAS",
        "middle_name": "TAYLOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-18",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "58308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, KY

Sources for this page

Verify at the official NPI Registry.