Individual provider Active NPI

Thomas Michael Luczkow, MSW

  • Clinical Social Worker
  • White Oak, PA
National Provider Identifier
1124176219
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW012063 Issued in PA
Practice address
1540 R. Lincoln Way
White Oak, PA 15131
Phone
(724) 327-1882
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW012063 PA Primary

Addresses

Primary practice location

1540 R. Lincoln Way
White Oak, PA 15131

Mailing address

3221 Mayer Dr
Murrysville, PA 15668-1617
Phone (724) 327-3352

Other identifiers 1

IdentifierTypeStateIssuer
417439OtherPAHIGHMARK BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100707000493 PA Practitioner - Clinical Social Worker 6901937903 Practice locations: White Oak, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1801 Lincoln Way
Suite 2
White Oak, PA 15131-1724
Phone (724) 327-1882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124176219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 MAYER DR",
            "city": "MURRYSVILLE",
            "state": "PA",
            "postal_code": "156681617",
            "telephone_number": "724-327-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 R. LINCOLN WAY",
            "city": "WHITE OAK",
            "state": "PA",
            "postal_code": "15131",
            "telephone_number": "724-327-1882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCZKOW",
        "first_name": "THOMAS",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW012063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BCBS",
            "identifier": "417439",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Oak, PA

Sources for this page

Verify at the official NPI Registry.