Individual provider Active NPI

Kathryn Courtney Luck, PA

  • Physician Assistant
  • Peabody, MA
National Provider Identifier
1114134442
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
964 Issued in MA
Practice address
Lahey Medical Center, Peabody
1 Essex Center Drive
Peabody, MA 01960-2901
Phone
(978) 538-4267
Fax
(978) 538-4706
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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 964 MA Primary

Addresses

Primary practice location

Lahey Medical Center, Peabody
1 Essex Center Drive
Peabody, MA 01960-2901

Mailing address

Lahey Hospital & Medical Center
41 Mall Road
Burlington, MA 01805-0001
Phone (781) 744-8650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20090218000511 MA Practitioner - Physician Assistant 0042373920 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

1 Essex Ctr Dr
Peabody, MA 01960-2901
Phone (978) 538-4000

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
964MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc. CurrentSince Dec 3, 2018 Accepting new patients
Lahey Clinic, Inc CurrentSince Feb 18, 2019 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

260 Cochituate Rd
Framingham, MA 01701
Phone (508) 628-9660

25 Highland Ave
Newburyport, MA 01950
Phone (978) 258-4734

1 Essex Dr
Peabody, MA 01960
Phone (978) 538-4000

Interoperability endpoints

  • Direct secure messaging: kluck114243@direct.bilh.masshiway.net

Organizations & group practices 2

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 3

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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1114134442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LAHEY HOSPITAL & MEDICAL CENTER",
            "address_2": "41 MALL ROAD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-8650",
            "fax_number": "781-744-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LAHEY MEDICAL CENTER, PEABODY",
            "address_2": "1 ESSEX CENTER DRIVE",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602901",
            "telephone_number": "978-538-4267",
            "fax_number": "978-538-4706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCK",
        "first_name": "KATHRYN",
        "middle_name": "COURTNEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.