Individual provider Active NPI

John C. Luke, MD

  • Family Medicine Physician
  • Rancho Cordova, CA
National Provider Identifier
1265593701
Registry record updated Jul 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C52740 Issued in CA
Practice address
3201 Data Drive
Rancho Cordova, CA 95670-7374
Phone
(916) 851-1440
Fax
(916) 635-7491
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C52740 CA Primary

Addresses

Primary practice location

3201 Data Drive
Rancho Cordova, CA 95670-7374

Mailing address

3201 Data Drive
Rancho Cordova, CA 95670-7374
Phone (916) 851-1440

Other identifiers 1

IdentifierTypeStateIssuer
8466575MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080116000844 CA Practitioner - Family Practice 2860591039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3201 Data Dr
Rancho Cordova, CA 95670-7374
Phone (916) 851-1424

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C52740CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Feb 1, 2008 Accepting new patients
Regents of the University of California CurrentSince Feb 1, 2008 Accepting new patients
Essent PRMC LP Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

3201 Data Dr
Rncho Cordova, CA 95670
Phone (916) 851-1424

4900 Broadway
Ste 1200
Sacramento, CA 95820
Phone (916) 734-9255

500 University Ave
Ste 220
Sacramento, CA 95825
Phone (916) 286-8700

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341532800000",
    "number": "1265593701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 DATA DRIVE",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707374",
            "telephone_number": "916-851-1440",
            "fax_number": "916-635-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 DATA DRIVE",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707374",
            "telephone_number": "916-851-1440",
            "fax_number": "916-635-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKE",
        "first_name": "JOHN",
        "middle_name": "C.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2012-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C52740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8466575",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

Verify at the official NPI Registry.