Individual provider Active NPI

David H Lucas, MD

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Clermont, FL
National Provider Identifier
1336131069
Registry record updated Dec 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
License
ME0057701 Issued in FL
Practice address
2020 Oakley Seaver Dr
Clermont, FL 34711
Phone
(352) 242-0404
Fax
(352) 242-5278
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X ME0057701 FL Primary

Addresses

Primary practice location

2020 Oakley Seaver Dr
Clermont, FL 34711

Mailing address

2020 Oakley Seaver Dr
Clermont, FL 34711
Phone (352) 242-0404

Other identifiers 2

IdentifierTypeStateIssuer
375475800MedicaidFL
25344ZOtherFLMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20080301000108 FL Practitioner - Orthopedic Surgery 4587748447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.5 of 100Reported as group
Quality
92.99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0057701FLMDSports Medicine (Neuromusculoskeletal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Business Alliance Inc CurrentSince Sep 1, 1994 Accepting new patients
Physician Business Alliance Inc Current Accepting new patients

Locations

2020 Oakley Seaver Dr
Clermont, FL 34711
Phone (352) 242-0404

2020 Oakley Seaver Dr
Ste 3
Clermont, FL 34711
Phone (352) 242-0404

Interoperability endpoints

  • Direct secure messaging: dlucas@smi.gwaydirect.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385942400000",
    "number": "1336131069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 OAKLEY SEAVER DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "34711",
            "telephone_number": "352-242-0404",
            "fax_number": "352-242-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 OAKLEY SEAVER DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "34711",
            "telephone_number": "352-242-0404",
            "fax_number": "352-242-5278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "DAVID",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2013-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME0057701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375475800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "25344Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.