Elisabeth B Lucassen, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MD442766 Issued in PA

Practice address

30 Hope Dr Ste 1300
Hershey, PA 17033-2036

Phone

(717) 531-3828

Fax

(717) 531-4694

NPI assigned

May 11, 2007

Reactivated

Feb 11, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1235344458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HOPE DR STE 1300",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332036",
            "telephone_number": "717-531-3828",
            "fax_number": "717-531-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCASSEN",
        "first_name": "ELISABETH",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2010-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD442766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027927460001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "262805",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elucassen855807@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9135 SW Barnes Rd Ste 461",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy Lu, MD, PHD
• Daphne Lu, MD
• Jeffrey S Lubin, MD
• Sara Lucak, PT
• Megan L Lucas, CRNP
• Steven E Lucking, MD
• Anna Sophia Ludkiewicz, PA-C
• Lindsay K Ludwick, CRNP
• Ashley Rae Ludwig, D.O.
• Anita C Lugo, CRNP

• Neurology Physician in Hershey, PA
• Providers in Hershey, PA by specialty
• Neurology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.