Active NPI
Yacub Lucas
- Nursing Home Administrator
- Sacramento, CA
National Provider Identifier
1235843467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Home Administrator
- License
- 6051257740
- Practice address
- 974 Park Ranch Way
Sacramento, CA 95831-3064 - Phone
- (916) 997-9130
- Fax
- (916) 515-8013
- NPI assigned
- Jan 11, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Home Administrator | 376G00000X | 6051257740 | CA | Primary |
Addresses
Primary practice location
974 Park Ranch Way
Sacramento, CA 95831-3064
Mailing address
974 Park Ranch Way
Sacramento, CA 95831-3064
Phone (916) 997-9130
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6051257740 | CA | MD | Nursing Home Administrator |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Canterbury House | Current | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673395200000",
"number": "1235843467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "974 PARK RANCH WAY",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958313064",
"telephone_number": "916-997-9130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "974 PARK RANCH WAY",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958313064",
"telephone_number": "916-997-9130",
"fax_number": "916-515-8013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCAS",
"first_name": "YACUB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-01-11",
"last_updated": "2023-01-11",
"certification_date": "2023-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "376G00000X",
"taxonomy_group": "",
"desc": "Nursing Home Administrator",
"state": "CA",
"license": "6051257740",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.