Kim L Lucas, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

22059 Issued in AZ

Practice address

5620 W Thunderbird Rd
Suite C-1
Glendale, AZ 85306-4636

Phone

(602) 938-6960

Fax

(602) 938-6069

NPI assigned

Nov 27, 2007

Last updated

Jun 26, 2014By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kim.lucas@340587261919236.direct.elationemr.com

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.

• Summit Medical Group Arizona LLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1053810622

  Internal Medicine

  Medicare reassignment NPD
• Thunderbird Internal Medicine

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1194083519
  NPD (past)

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1285816777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 W THUNDERBIRD RD",
            "address_2": "SUITE F-1",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064636",
            "telephone_number": "602-938-6960",
            "fax_number": "602-938-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 W THUNDERBIRD RD",
            "address_2": "SUITE C-1",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064636",
            "telephone_number": "602-938-6960",
            "fax_number": "602-938-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "KIM",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-27",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "22059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Patrick Lozon, M.D.
• Hsin-Ju Lu
• Mark Clinton Luba, MD
• Susan T. Luberto, D.O.
• Jessica Lorraine Lucas, R-MA
• Rudolph Lucas
• Kamryn Lucero, PT, DPT
• Matthew Lucht, AT
• Lorraine Luciano, LPC
• Tristin Renee Lucier, BS

• Internal Medicine Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; 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.