Individual provider Active NPI

Lucas Alexander Walk, DO

  • Family Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1184204554
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
011057 Issued in AZ
Practice address
8901 E Raintree Dr Ste 150
Scottsdale, AZ 85260-7110
Phone
(480) 733-7600
Fax
(602) 805-2816
NPI assigned
Apr 10, 2021
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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 011057 AZ Primary

Addresses

Primary practice location

8901 E Raintree Dr Ste 150
Scottsdale, AZ 85260-7110

Mailing address

3265 Creek Rd
Park City, UT 84098-4846
Phone (435) 659-5518

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Scottsdale Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240719002114 AZ Practitioner - Family Practice 2668918236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846
Phone (623) 876-3800

7669 E Pinnacle Peak Rd
Suite 220
Scottsdale, AZ 85255-3220
Phone (480) 764-1937

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011057AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Primary Care Physicians Arizona LLC CurrentSince Aug 19, 2024 Accepting new patients
Banner Primary Care Physicians Arizona LLC Current Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Aug 19, 2024 Accepting new patients

Locations

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

7669 E Pinnacle Peak Rd
Ste 220
Scottsdale, AZ 85255
Phone (480) 733-7600

8901 E Raintree Dr
Ste 150
Scottsdale, AZ 85260
Phone (480) 733-7600

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1618012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1184204554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3265 CREEK RD",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840984846",
            "telephone_number": "435-659-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 E RAINTREE DR STE 150",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852607110",
            "telephone_number": "480-733-7600",
            "fax_number": "602-805-2816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALK",
        "first_name": "LUCAS",
        "middle_name": "ALEXANDER",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-10",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "011057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Scottsdale",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8901 E Raintree Dr Ste 150",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852607110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.