Tyler Jacob Lucas, DO

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

02006385A Issued in IN

Practice address

301 Satori Pkwy Ste 120
Avon, IN 46123-6407

Phone

(317) 718-4263

Fax

(317) 272-7855

NPI assigned

Apr 11, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Sports Medicine

Education

Marian University College of Osteopathic Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hendricks County HospitalGroup PAC ID 4880505528, 341 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hendricks Regional Health Hospital, Danville, IN, CCN 150005

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tlucas1142654@direct.trinity-health.org
• Direct secure messaging: tlucas384156@direct-prd.stelizabeth.com
• FHIR API: https://sehproxy.stelizabeth.com/arr-fhir/api/FHIR/R4

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.

• Hendricks County Hospital

  dba HRH Associate Health

  • General Practice Physician
  • Danville, IN
  • NPI 1497536163
  Medicare reassignment Care Compare group NPD
• Hendricks County Hospital

  dba Orthopedics & Sports Medicine of Indiana

  • Sports Medicine (Family Medicine) Physician
  • Avon, IN
  • NPI 1356438709
  NPD
• Hendricks County Hospital

  dba Hendricks Pediatrics of Brownsburg

  • Pediatrics Physician
  • Brownsburg, IN
  • NPI 1508758210
  NPD
• Hendricks County Hospital

  dba Hendricks Regional Health Immediate Care

  • Urgent Care Clinic/Center
  • Avon, IN
  • NPI 1063411551
  NPD (past)
• Hendricks County Hospital

  dba Stafford Pointe Family Physicians

  • Family Medicine Physician
  • Plainfield, IN
  • NPI 1104927557
  NPD (past)
• Hendricks County Hospital

  dba Avon Family Health

  • Family Medicine Physician
  • Avon, IN
  • NPI 1598993784
  NPD (past)

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

• Hendricks County Hospital

  • General Acute Care Hospital
  • Danville, IN
  • NPI 1669475950
  Care Compare affiliation

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1295232643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SATORI PKWY STE 120",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461236407",
            "telephone_number": "317-718-4863",
            "fax_number": "317-272-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SATORI PKWY STE 120",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461236407",
            "telephone_number": "317-718-4263",
            "fax_number": "317-272-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "TYLER",
        "middle_name": "JACOB",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-11",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11019906A",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IN",
            "license": "02006385A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista L Lorenz, FNP
• Rachel Nicole Lorenz, PA-C
• Benjamin Lorenzana
• Chloe Loudermilk
• Jingfei Lu, PA-C
• Luving Hands Home Care LLC
• Luxottica of America Inc (Target Optical #2007)
• Robert Lyle
• Maria Rose Mabe, M.S.CCC-SLP
• Kyle Reece Mackey, MD

• Sports Medicine (Family Medicine) Physician in Avon, IN
• Providers in Avon, IN by specialty
• Sports Medicine (Family Medicine) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.