Individual provider Active NPI

Lutchana Coley

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1093262834
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
17TH West 9TH Street
Brooklyn, NY 11231
Phone
(718) 599-9090
NPI assigned
Sep 9, 2016
Last updated
May 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

17TH West 9TH Street
Brooklyn, NY 11231

Mailing address

601 Stowe Ave
North Baldwin, NY 11510-1701
Phone (203) 524-2303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20180807002252 NY Practitioner - Physician Assistant 2365721875 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercy College, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Lij Urgent Care PCGroup PAC ID 6002131778, 389 clinicians
Crown Heights Medical PCGroup PAC ID 1850794843, 2 clinicians
Sinai Urgent Medical Care PCGroup PAC ID 5799125852, 2 clinicians

Practice addresses (Care Compare)

1950 Jericho Tpke
East Northport, NY 11731-6207
Phone (631) 238-3065

314 Bradley Ave
Staten Island, NY 10314-5171
Phone (718) 534-0689

377 S Oyster Bay Rd
Plainview, NY 11803-3323
Phone (516) 537-9061

50 E Jericho Tpke
Mineola, NY 11501-3141
Phone (516) 399-3068

5145 Nesconset Hwy
Suite 4
Port Jefferson Station, NY 11776-2118
Phone (347) 493-2945

527 Boulevard E
Yaphank, NY 11980-7512
Phone (631) 504-0427

600 N Wellwood Ave
Suite H
Lindenhurst, NY 11757-2000
Phone (631) 412-8903

603 E Main St
B
Bay Shore, NY 11706-8505
Phone (631) 238-3064

839 New York Ave
Huntington, NY 11743-4412
Phone (347) 728-1604

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ilyagu Medical PC Past Accepting new patients
QHC Upstate Medical, P.C. PastSince Jan 1, 2018 Accepting new patients

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1093262834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 STOWE AVE",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115101701",
            "telephone_number": "203-524-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17TH WEST 9TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11231",
            "telephone_number": "718-599-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEY",
        "first_name": "LUTCHANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-09",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.