Baotram Ngoc Luu, PA-C, MPAS

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA051657 Issued in PA

Practice address

One Medical Center Blvd
Suite 404
Upland, PA 19013

Phone

(610) 619-8590

Fax

(610) 619-8591

NPI assigned

Jun 26, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Health Access Network

  • Physical Medicine & Rehabilitation Physician
  • Chester, PA
  • NPI 1356460380
  NPD (past)

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404172800000",
    "number": "1194130328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER BLVD",
            "address_2": "SUITE 404",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "19013",
            "telephone_number": "610-619-8590",
            "fax_number": "610-619-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER BLVD",
            "address_2": "SUITE 404",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "19013",
            "telephone_number": "610-619-8590",
            "fax_number": "610-619-8591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUU",
        "first_name": "BAOTRAM",
        "middle_name": "NGOC",
        "credential": "PA-C, MPAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2014-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051657",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly M Langmuir, M.D
• James D Lebedda, MD
• Lawrence S Levit, MD
• Tanika Reontae Long, M.D.
• Roland Bruce Lutz, MD
• Humaira Mahbub, MD
• Erin Marie Mannella, CRNP
• Margaret Marcinik, DO
• Roy G. Marcus, M.D.
• Daniel Christopher Marotta, M.D.

• Medical Physician Assistant in Upland, PA
• Providers in Upland, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.