Lucas Elliott Haldeman, PA
Individual provider Active NPI Medical Physician Assistant · Denver, PA
NPI 1306500889 · NPPES record last updated Nov 1, 2021
Key facts
- NPI
- 1306500889
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- MA063066 (PA)
- Practice address
- 111 Ironwood CT
Denver, PA 17517-8619 - Phone
- (717) 940-9262
- NPI assigned
- Oct 29, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 20
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Reading Hospital
Practice addresses (Care Compare)
206 S 6TH Ave
West Reading, PA 19611-1411
Phone (484) 628-5437
301 S 7TH Ave
Suite 2020
West Reading, PA 19611-1495
Phone (610) 375-6565
420 S 5TH Ave
West Reading, PA 19611-2143
420 S 5TH Ave BLDG N
West Reading, PA 19611-2143
Hospital & facility affiliations
- Reading Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211105002640 | PA | Practitioner - Physician Assistant | 7012306491 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA063066 | PA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tower Health Medical Group | Current |
Accepting new patients | |
| Tower Health Medical Group | Current |
Accepting new patients | |
| Wellspan Medical Group | Current |
Accepting new patients | |
| Wellspan Medical Group | Current |
Accepting new patients | |
| Reading Hospital | Current |
Accepting new patients | |
| Reading Hospital | Current |
Accepting new patients | |
| Reading Professional Services | Past | Accepting new patients |
Locations
31 Industrial Dr
Ste 150
Hamburg, PA 19526
Phone (610) 376-8671
8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227
206 S 6th Ave
West Reading, PA 19611
Phone (484) 628-5437
301 S 7th Ave
Ste 2020
West Reading, PA 19611
1320 Broadcasting Rd
Ste 107
Wyomissing, PA 19610
Phone (484) 628-0319
1320 Broadcasting Rd
Ste 100
Wyomissing, PA 19610
2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127
1600 S George St
York, PA 17403
Phone (717) 848-3615
25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250
3421 Concord Rd
York, PA 17402
Phone (717) 851-2441
Interoperability endpoints
- lhaldeman757745@direct.ahn.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | MA063066 | PA | Yes |
| Physician Assistant | 363A00000X | OA005841 | PA |
Addresses
Primary practice location
111 Ironwood CT
Denver, PA 17517-8619
Mailing address
3421 Concord Rd
York, PA 17402-9001
Phone (717) 851-1405
Other providers in Denver, PA
- William C. Funk
- Maribeli Galan
- Kelley Gallen
- Gordon Guinette
- Meghan Guyette
- Hallelujah LLC
- Hand Crafted Counseling Services
- Roger William Hannah Jr.
- Julia Hansen
- Heart of a&O Home Healthcare, LLC
All providers in Denver, PA · Medical Physician Assistant in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.