Individual provider Active NPI

Danica Luc, PA-C

  • Surgical Physician Assistant
  • Rochester, NY
National Provider Identifier
1134877533
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
029747 Issued in NY
Practice address
1555 Long Pond Rd FL 1
Rochester, NY 14626-4164
Phone
(585) 723-7281
NPI assigned
Mar 15, 2022
Last updated
Aug 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 029747 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1555 Long Pond Rd FL 1
Rochester, NY 14626-4164

Mailing address

1102 Central Park Blvd N
Greenwood, IN 46143-7310

Other practice location 1

1102 Central Park Blvd N
Greenwood, IN 46143-7310
Phone (516) 675-7091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230508001377 NY Practitioner - Physician Assistant 1355706789 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

82 Holland St
Rochester, NY 14605-2131
Phone (585) 423-5800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. CurrentSince Oct 12, 2024 Accepting new patients
Western New York Medical Practice P.C CurrentSince Oct 12, 2024 Accepting new patients
The Unity Hospital of Rochester CurrentSince May 1, 2023 Accepting new patients
Anthony L. Jordan Health Corporation Current Accepting new patients
The Unity Hospital of Rochester CurrentSince May 1, 2023 Accepting new patients

Locations

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

1555 Long Pond Rd
Fl 1
Rochester, NY 14626
Phone (585) 723-7000

214 Lake Ave
#A
Rochester, NY 14608
Phone (585) 784-5901

82 Holland St
Rochester, NY 14605
Phone (585) 423-5800

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1134877533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 CENTRAL PARK BLVD N",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461437310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD FL 1",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264164",
            "telephone_number": "585-723-7281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1102 Central Park Blvd N",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "IN",
            "postal_code": "461437310",
            "country_code": "US",
            "telephone_number": "516-675-7091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUC",
        "first_name": "DANICA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-15",
        "last_updated": "2023-08-17",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "029747",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.