Lucas Anissian, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

ME111701 Issued in FL

Practice address

4689 US Highway 17
Fleming Island, FL 32003-4831

Phone

(904) 269-7007

Fax

(904) 269-0529

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

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.

• Jacksonville Multispecialty Services, LLC

  dba First Coast Orthopedics

  • Orthopaedic Surgery Physician
  • Orange Park, FL
  • NPI 1427298363
  NPD (past)
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD (past)
• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  Orthopaedic Surgery

  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1285669390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 KINGSLEY AVE",
            "address_2": "SUITE 107",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734490",
            "telephone_number": "904-269-6565",
            "fax_number": "904-269-0529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4689 US HIGHWAY 17",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034831",
            "telephone_number": "904-269-7007",
            "fax_number": "904-269-0529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANISSIAN",
        "first_name": "LUCAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "LA",
            "license": "201054",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME111701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1582956",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ervin Alston
• Jamari Anderson
• Stacie Lynn Anderson, LCSW
• Angela White Arnp PLLC
• Angela White Arnp PLLC
• Richard Anteau II
• Arlene Aquino, APRN
• Carissa D Aquino, DPT
• Valentina Arismendy
• Hannah Arnold Arnold

• Orthopaedic Surgery Physician in Fleming Island, FL
• Providers in Fleming Island, FL by specialty
• Orthopaedic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; 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.