NPIMap

Individual provider Active NPI

Elliott W Lucas, MD

  • Obstetrics & Gynecology Physician
  • Norfolk, VA
National Provider Identifier
1124128111
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
0101042387 Issued in VA
Practice address
100 Kingsley LN
Suite 100
Norfolk, VA 23505-4604
Phone
(757) 889-6890
Fax
(757) 889-6893
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X D69405 MD
Obstetrics & Gynecology Physician 207V00000X 0101042387 VA Primary

Addresses

Primary practice location

100 Kingsley LN
Suite 100
Norfolk, VA 23505-4604

Mailing address

100 Kingsley LN
Suite 100
Norfolk, VA 23505-4604
Phone (757) 889-6890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, SC, MD3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040611000244 VA Practitioner - Obstetrics/Gynecology 7911980735 Reassigns benefits to 1 organization
I20171016001494 SC Practitioner - Obstetrics/Gynecology 7911980735 Reassigns benefits to 1 organization
I20201103000310 MD Practitioner - Obstetrics/Gynecology 7911980735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Howard University College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Obhg Virginia LLCGroup PAC ID 9436323342, 46 clinicians

Practice addresses (Care Compare)

1401 Johnston Willis Dr
North Chesterfield, VA 23235-4730
Phone (864) 908-3530

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beaufort Jasper Hampton Comprehensive Health Services, Inc. CurrentSince Jul 25, 2017 Accepting new patients
Obhg Maryland PC Obstetrics & Gynecology CurrentSince Oct 6, 2020 Accepting new patients
Obhg Maryland PC Obstetrics & Gynecology CurrentSince Oct 6, 2020 Accepting new patients

Locations

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

777 Lowndes Hill Rd
Bldg 1
Greenville, SC 29607
Phone (864) 908-3736

721 Okatie Hwy
Okatie, SC 29909

Organizations & group practices 4

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1124128111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGSLEY LN",
            "address_2": "SUITE 100",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054604",
            "telephone_number": "757-889-6890",
            "fax_number": "757-889-6893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KINGSLEY LN",
            "address_2": "SUITE 100",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054604",
            "telephone_number": "757-889-6890",
            "fax_number": "757-889-6893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "ELLIOTT",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D69405",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101042387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.