NPIMap

Organization Active NPI

MCL Primary Care, LLC.

  • Family Medicine Physician
  • Ivyland, PA
National Provider Identifier
1114251816
Registry record updated Nov 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS014106 Issued in PA
Legal business name
MCL PRIMARY CARE, LLC.
Practice address
882 Jacksonville Rd
Suite 204
Ivyland, PA 18974-4836
Phone
(215) 957-1100
Fax
(215) 957-1111
NPI assigned
Sep 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2009

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

Authorized official

Name
Dr. Michael C. Luciano, D.O.
Title
Physician/Owner
Phone
(215) 957-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS014106 PA Primary

Addresses

Primary practice location

882 Jacksonville Rd
Suite 204
Ivyland, PA 18974-4836

Mailing address

882 Jacksonville Rd
Suite 204
Ivyland, PA 18974-4836
Phone (215) 957-1100

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258329600000",
    "number": "1114251816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 JACKSONVILLE RD",
            "address_2": "SUITE 204",
            "city": "IVYLAND",
            "state": "PA",
            "postal_code": "189744836",
            "telephone_number": "215-957-1100",
            "fax_number": "215-957-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 JACKSONVILLE RD",
            "address_2": "SUITE 204",
            "city": "IVYLAND",
            "state": "PA",
            "postal_code": "189744836",
            "telephone_number": "215-957-1100",
            "fax_number": "215-957-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCL PRIMARY CARE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-28",
        "last_updated": "2009-11-16",
        "status": "A",
        "authorized_official_last_name": "LUCIANO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "215-957-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS014106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ivyland, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; 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.