Active NPI
Little Lantern Clinic LLC
- General Practice Physician
- Carrollton, TX
National Provider Identifier
1114409133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- M7387
- Legal business name
- LITTLE LANTERN CLINIC LLC
- Practice address
- 4541 N Josey LN Ste 110
Carrollton, TX 75010-4622 - Phone
- (469) 788-8588
- Fax
- (469) 788-7800
- NPI assigned
- Sep 6, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Biju Lukose, MD
- Title
- Director
- Phone
- (469) 788-8545
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | |||
| Gastroenterology Physician | 207RG0100X | |||
| Surgery Physician | 208600000X | |||
| General Practice Physician | 208D00000X | M7387 | TX | Primary |
Addresses
Primary practice location
4541 N Josey LN Ste 110
Carrollton, TX 75010-4622
Mailing address
4541 N Josey LN Ste 110C
Carrollton, TX 75010-4622
Phone (469) 788-8588
Other practice location 1
9 Medical Pkwy Fl 2
Farmers Branch, TX 75234-7858
Phone (469) 788-8588
Other practice location 2
4323 N Josey Ln Ste 100
Carrollton, TX 75010-4619
Phone (469) 788-8588
Other names 4
- US Clinics
- US Medical Clinics
- US Surgical Clinics
- US Visiting MD
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181003001751 | TX | Part B Supplier - Clinic/Group Practice | 0446502322 |
Receives reassigned benefits from 22 practitioners Practice locations: Austin, TX; Carrollton, TX; McKinney, TX; Missouri City, TX; Plano, TX |
National Provider Directory
National Provider DirectoryLocations
10025 Anderson Mill Rd
Austin, TX 78750
4541 N Josey Ln
Ste 110C
Carrollton, TX 75010
9 Medical Pkwy
Fl 2
Farmers Branch, TX 75234
1601 Eldorado Pkwy
McKinney, TX 75069
Phone (214) 548-5449
7070 Knights Ct
Ste 703
Missouri City, TX 77459
1301 Custer Rd
Ste 400
Plano, TX 75075
Phone (469) 261-1774
Practitioners & affiliated clinicians
Practitioners 22
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Primary Care Nurse Practitioner
- Dallas, TX
- NPI 1972208726
Multi-Specialty, TX
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536192000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1719878400000",
"number": "1114409133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4541 N JOSEY LN STE 110C",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "750104622",
"telephone_number": "469-788-8588",
"fax_number": "469-788-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4541 N JOSEY LN STE 110",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "750104622",
"telephone_number": "469-788-8588",
"fax_number": "469-788-7800"
}
],
"practiceLocations": [
{
"address_1": "9 Medical Pkwy Fl 2",
"address_purpose": "LOCATION",
"city": "Farmers Branch",
"state": "TX",
"postal_code": "752347858",
"country_code": "US",
"telephone_number": "469-788-8588",
"fax_number": "469-788-7800",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4323 N Josey Ln Ste 100",
"address_purpose": "LOCATION",
"city": "Carrollton",
"state": "TX",
"postal_code": "750104619",
"country_code": "US",
"telephone_number": "469-788-8588",
"fax_number": "469-788-7800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "LITTLE LANTERN CLINIC LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-09-06",
"last_updated": "2024-07-02",
"certification_date": "2024-07-02",
"status": "A",
"authorized_official_last_name": "LUKOSE",
"authorized_official_first_name": "BIJU",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "469-788-8545",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": "TX",
"license": "M7387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "US Clinics",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "US Medical Clinics",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "US Surgical Clinics",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "US Visiting MD",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Carrollton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.