NPIMap

Individual provider Active NPI

John C. Lucio, D.O.

  • Interventional Pain Medicine Physician
  • Jefferson City, MO
National Provider Identifier
1316932957
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
109799 Issued in MO
Practice address
2505 Mission Dr
Suite 200
Jefferson City, MO 65109-9508
Phone
(573) 681-3759
Fax
(573) 681-3659
NPI assigned
Sep 20, 2005
Last updated
Dec 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 109799 MO
Interventional Pain Medicine Physician 208VP0014X 109799 MO Primary

Addresses

Primary practice location

2505 Mission Dr
Suite 200
Jefferson City, MO 65109-9508

Mailing address

2505 Mission Dr
Suite 200
Jefferson City, MO 65109-9508
Phone (573) 681-3759

Other identifiers 2

IdentifierTypeStateIssuer
050050621OtherMORR MEDICARE
248216806MedicaidMO

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jlucio12341@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.smhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100227000008 MO Practitioner - Pain ManagementPractitioner - Anesthesiology 8729123989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Michigan State University College of Osteopathic Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Regional Health ServicesGroup PAC ID 8921917352, 165 clinicians

Practice addresses (Care Compare)

2505 Mission Dr
Suite 200
Jefferson City, MO 65109-9508
Phone (573) 681-3759

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as group
Quality
86.39
Promoting interoperability
100
Improvement activities
40
Cost
73.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109799MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Regional Health Services CurrentSince Jan 2, 2015 Accepting new patients
SSM Regional Health Services CurrentSince Jan 2, 2015 Accepting new patients
SSM Regional Health Services Past Accepting new patients

Locations

100 Saint Marys Plz
Jefferson Cty, MO 65101
Phone (573) 635-7642

Interoperability endpoints

  • Direct secure messaging: jlucio12341@direct-ehr-ssmhc.com

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1316932957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 MISSION DR",
            "address_2": "SUITE 200",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651099508",
            "telephone_number": "573-681-3759",
            "fax_number": "573-681-3659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 MISSION DR",
            "address_2": "SUITE 200",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651099508",
            "telephone_number": "573-681-3759",
            "fax_number": "573-681-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIO",
        "first_name": "JOHN",
        "middle_name": "C.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "109799",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MO",
            "license": "109799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "050050621",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "248216806",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlucio12341@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jlucio12341@direct-ehr-ssmhc.com",
            "address_1": "2505 Mission Dr",
            "address_2": "Suite 200",
            "city": "Jefferson City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "651099508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.smhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2505 Mission Dr",
            "address_2": "Suite 200",
            "city": "Jefferson City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "651099508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.