Individual provider Active NPI

Maria A Lucchesi, PH.D.

  • Clinical Psychologist
  • Sunrise, FL
National Provider Identifier
1184807570
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY6795 Issued in FL
Practice address
1398 SW 160TH Ave Ste 302
Sunrise, FL 33326-1988
Phone
(305) 867-6856
Fax
(305) 397-1523
NPI assigned
Dec 9, 2007
Last updated
Feb 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY6795 FL Primary
Clinical Child & Adolescent Psychologist 103TC2200X PY6795 FL

Addresses

Primary practice location

1398 SW 160TH Ave Ste 302
Sunrise, FL 33326-1988

Mailing address

1398 SW 160TH Ave Ste 302
Sunrise, FL 33326-1988
Phone (305) 867-6856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090814000650 FL Practitioner - Clinical Psychologist 8628122363 Practice locations: Sunrise, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1398 SW 160TH Ave
Suite 302
Sunrise, FL 33326-1988
Phone (305) 867-6856

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY6795FLMDClinical Child & Adolescent Psychologist

Organizations & group practices 1

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": "1197158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1184807570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1398 SW 160TH AVE STE 302",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333261988",
            "telephone_number": "305-867-6856",
            "fax_number": "305-397-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1398 SW 160TH AVE STE 302",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333261988",
            "telephone_number": "305-867-6856",
            "fax_number": "305-397-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCCHESI",
        "first_name": "MARIA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-09",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6795",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY6795",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

Verify at the official NPI Registry.