NPIMap

Individual provider Active NPI

David Luo

  • Family Medicine Physician
  • Stratford, CT
National Provider Identifier
1164957379
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
82834 Issued in CT
Practice address
2900 Main St
Stratford, CT 06614-4946
Phone
(203) 378-3080
NPI assigned
Apr 25, 2017
Last updated
Nov 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 82834 CT Primary

Addresses

Primary practice location

2900 Main St
Stratford, CT 06614-4946

Mailing address

2900 Main St
Stratford, CT 06614-4946
Phone (203) 378-3080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CT2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20200909002673 PA Practitioner - Family Practice 4284971268 Reassigns benefits to 1 organization
I20260209002294 CT Practitioner - Family Practice 4284971268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

1 Outlet LN
Suite 400
Lock Haven, PA 17745-7815
Phone (570) 769-1300

2000 Westinghouse Dr
Cranberry Township, PA 16066-5238

2900 Main St
Suite 3a
Stratford, CT 06614-4946
Phone (203) 383-4323

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.06 of 100Reported as group
Quality
62.07
Promoting interoperability
100
Improvement activities
40
Cost
74.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82834CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Susquehanna Physician Services CurrentSince Sep 1, 2020 Accepting new patients
Susquehanna Physician Services Family Medicine CurrentSince Sep 1, 2020 Accepting new patients
Primed, LLC PastSince Jan 1, 2026 Accepting new patients

Locations

2900 Main St
Stratford, CT 06614
Phone (203) 372-0649

2900 Main St
Ste 3A
Stratford, CT 06614
Phone (203) 383-4323

2900 Main St
Ste 3C
Stratford, CT 06614
Phone (203) 377-3080

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

1 Outlet Ln
Ste 400
Lock Haven, PA 17745
Phone (570) 326-8080

610 High St
Lock Haven, PA 17745
Phone (570) 748-1260

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

1201 Grampian Blvd
Ste 400
Williamsport, PA 17701

700 High St
Williamsport, PA 17701
Phone (570) 321-2000

Interoperability endpoints

  • Direct secure messaging: david.x.luo@upmcdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1164957379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 MAIN ST",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066144946",
            "telephone_number": "203-378-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 MAIN ST",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066144946",
            "telephone_number": "203-378-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUO",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-25",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "82834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, CT

Sources for this page

Verify at the official NPI Registry.