Lucky Care Medical, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

167799 Issued in NY

Legal business name

LUCKY CARE MEDICAL, PC

Practice address

2108 2ND Ave
New York, NY 10029-3731

Phone

(212) 876-8590

Fax

(212) 360-1844

NPI assigned

Apr 7, 2008

Organization subpart

No

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

Authorized official

Name

Clyde Lucky, M.D.

Title

President

Phone

(212) 876-8590

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas George, DPM

  • Podiatrist
  • Staten Island, NY
  • NPI 1457334583
  NPD (past)

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1174796650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13876 QUEENS BLVD FL 1",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "114352930",
            "telephone_number": "718-850-6345",
            "fax_number": "718-559-4895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100293731",
            "telephone_number": "212-876-8590",
            "fax_number": "212-360-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCKY CARE MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "LUCKY",
        "authorized_official_first_name": "CLYDE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-876-8590",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "167799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01029056",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Savannah Jane Lucio, PA-C
• Linda Lucious
• Amy Luckert, PHYSICIAN ASSISTANT
• Fran Sue Luckom Nurnberg, PHD
• Peter Luckow
• Lucky Express Corp.
• Lucky Health Pharmacy Inc.
• Corrinn Lucotch, PA-C
• Scott Lucyk, MD
• Wallace Ludel

• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.