Active NPI
Lucas De Jong
- Family Medicine Physician
- Wichita, KS
National Provider Identifier
1164090528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 94-10748
- Practice address
- 1010 N Kansas St
Wichita, KS 67214-3124 - Phone
- (316) 293-2665
- NPI assigned
- Jun 14, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 94-10748 | KS | Primary |
Addresses
Primary practice location
1010 N Kansas St
Wichita, KS 67214-3124
Mailing address
1010 N Kansas St
Wichita, KS 67214-3124
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 E 10TH St
Suite 208
Spencer, IA 51301-4307
Phone (712) 264-6189
116 E 10TH St
Suite 101
Spencer, IA 51301-4365
Phone (712) 264-3500
1200 1St Ave E
Spencer, IA 51301-4330
1200 1St Ave E
Spencer, IA 51301-4342
Phone (712) 264-6198
1200 1St Ave E C
Nwia Bone Joint and Sports Surgeons
Spencer, IA 51301-4342
Phone (712) 262-7511
Hospital & facility affiliations
- Avera at Home of Spencer Hospital
- Sanford Home Health and Hospice Sheldon
- Avera @ Home of Spencer Hospital
- Spencer Municipal Hospital
- Lakes Regional Healthcare
- Avera Heart Hospital of South Dakota
- Avera McKennan Hospital & University Health Center
- Spencer Post Acute Rehabilitation Center
- St Luke Lutheran Nursing Home
- Ruthven Community Care Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.04 of 100
- Quality
- 89.99
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spencer Municipal Hospital | Current | Accepting new patients | |
| Spencer Municipal Hospital | Current | Accepting new patients | |
| Spencer Municipal Hospital | Current | Accepting new patients | |
| Spencer Municipal Hospital | Family Medicine | Current | Accepting new patients |
| Spencer Municipal Hospital | Past | Accepting new patients | |
| Northwest Iowa Dermatology LLC | Past | Accepting new patients |
Locations
2004 Okoboji Ave
Milford, IA 51351
Phone (712) 338-2461
101 E 10th St
Ste 101
Spencer, IA 51301
Phone (712) 264-3500
1200 1st Ave E
Ste 1
Spencer, IA 51301
Phone (712) 264-6160
1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164
Interoperability endpoints
- lucus.de.jong@avera.sdhealthlink.net
Organizations & group practices 6
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.
-
- Clinic/Center
- Milford, IA
- NPI 1396732186
-
- Clinic/Center
- Hartley, IA
- NPI 1225767338
-
- Orthopaedic Surgery Physician
- Spencer, IA
- NPI 1316432826
-
- Family Medicine Physician
- Spencer, IA
- NPI 1780062273
-
- Dermatology Physician
- Algona, IA
- NPI 1962217778
-
- Rural Acute Care Hospital
- Spencer, IA
- NPI 1255328621
Hospital & facility affiliations 36
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sioux Falls, SD
- NPI 1154531630
-
- General Acute Care Hospital
- Sioux Falls, SD
- NPI 1184834764
-
- Endocrinology, Diabetes & Metabolism Physician
- Sioux Falls, SD
- NPI 1396711016
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623628800000",
"number": "1164090528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 N KANSAS ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672143124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 N KANSAS ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672143124",
"telephone_number": "316-293-2665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE JONG",
"first_name": "LUCAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-14",
"last_updated": "2021-06-14",
"certification_date": "2021-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "94-10748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.