Individual provider Active NPI

Anne W Lucky, M.D.

  • Pediatric Dermatology Physician
  • Cincinnati, OH
National Provider Identifier
1285688150
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Dermatology PhysicianTaxonomy code 207NP0225X
License
35.049417 Issued in OH
Practice address
7691 5 Mile Rd
Ste. 312
Cincinnati, OH 45230-4348
Phone
(513) 232-3332
Fax
(513) 232-9635
NPI assigned
May 22, 2006
Last updated
Feb 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35-04-9417 OH
Pediatric Dermatology Physician 207NP0225X 35.049417 OH Primary

Addresses

Primary practice location

7691 5 Mile Rd
Ste. 312
Cincinnati, OH 45230-4348

Mailing address

7691 5 Mile Rd
Cincinnati, OH 45230-4348
Phone (513) 232-3332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20100329000746 OH Practitioner - DermatologyPractitioner - Pediatric Medicine 8628104775 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Pediatric Medicine
Education
Yale University School of Medicine, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatologists of Southwestern Ohio, LLCGroup PAC ID 7113973041, 116 clinicians

Practice addresses (Care Compare)

7691 5 Mile Rd
Suite 312
Cincinnati, OH 45230-4348
Phone (513) 232-3332

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Medical Center Pediatrics CurrentSince May 19, 2015 Accepting new patients
Dermatologists of Southwestern Ohio, LLC. CurrentSince Sep 1, 2014 Accepting new patients
Dermatology Associates of Cinti Inc Past Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

4243 Hunt Rd
Ste 100
Blue Ash, OH 45242

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

7691 5 Mile Rd
Ste 312
Cincinnati, OH 45230
Phone (513) 232-3332

5300 Far Hills Ave
Dayton, OH 45429
Phone (513) 433-7536

10506 Montgomery Rd
Ste 402
Montgomery, OH 45242
Phone (513) 791-6161

Interoperability endpoints

  • Direct secure messaging: awl@dermswohio.emadirect.md

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1285688150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7691 5 MILE RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452304348",
            "telephone_number": "513-232-3332",
            "fax_number": "513-232-9635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7691 5 MILE RD",
            "address_2": "STE. 312",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452304348",
            "telephone_number": "513-232-3332",
            "fax_number": "513-232-9635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKY",
        "first_name": "ANNE",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-04-9417",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "OH",
            "license": "35.049417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.