Timothy Michael Lucas, O. D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TO2350 Issued in MO

Practice address

4109 Union Rd
Saint Louis, MO 63129-1064

Phone

(314) 487-0700

Fax

(314) 487-1212

NPI assigned

Jan 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1154476455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15933 CLAYTON RD STE 201",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112172",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 UNION RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631291064",
            "telephone_number": "314-487-0700",
            "fax_number": "314-487-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "TIMOTHY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO2350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2202044",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "5268423",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "208725",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "32313",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH PLAN",
            "identifier": "53491",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Rochell Lucas, DNP, APRN
• Hunter Lucas, MD
• Jaree Lucas
• John Lucas, M.A., LPC
• Karen D Lucas, CRNA
• Todd Nicholes Lucas, O.D.
• Kerith Lucia Lucco, M.D.
• Brendan P Lucey, MD
• Gerald J Luchtefeld, CRNA
• Stephen James Luchtefeld, D.O.

• Optometrist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.