Active NPI
Lucas R Josephine, PA
- Physician Assistant
- North Kansas City, MO
National Provider Identifier
1194177543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2016023821
- Practice address
- 2800 Clay Edwards Drive
North Kansas City, MO 64116-4673 - Phone
- (816) 691-2000
- Fax
- (816) 346-7242
- NPI assigned
- Jul 11, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085006274 | IL | |
| Physician Assistant | 363A00000X | 2016023821 | MO | Primary |
Addresses
Primary practice location
2800 Clay Edwards Drive
North Kansas City, MO 64116-4673
Mailing address
PO Box 11157
Kansas City, MO 64119-0157
Phone (855) 381-3941
Other practice location 1
1000 Carondelet Dr
Kansas City, MO 64114-4673
Phone (816) 942-4400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
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 and National Provider Directory roles.
-
- Emergency Medicine Physician
- North Kansas City, MO
- NPI 1578556023
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543276800000",
"number": "1194177543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11157",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641190157",
"telephone_number": "855-381-3941",
"fax_number": "855-291-1862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 CLAY EDWARDS DRIVE",
"city": "NORTH KANSAS CITY",
"state": "MO",
"postal_code": "641164673",
"telephone_number": "816-691-2000",
"fax_number": "816-346-7242"
}
],
"practiceLocations": [
{
"address_1": "1000 Carondelet Dr",
"address_purpose": "LOCATION",
"city": "Kansas City",
"state": "MO",
"postal_code": "641144673",
"country_code": "US",
"telephone_number": "816-942-4400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOSEPHINE",
"first_name": "LUCAS",
"middle_name": "R",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-11",
"last_updated": "2018-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085006274",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MO",
"license": "2016023821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in North Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; 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.