Individual provider Active NPI

Angela McCarthy Lucas, MD

  • Family Medicine Physician
  • Brandon, FL
National Provider Identifier
1336458298
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME156701 Issued in FL
Practice address
500 Vonderburg Dr Ste 102
Brandon, FL 33511-5968
Phone
(813) 681-5658
Fax
(813) 681-5250
NPI assigned
Sep 27, 2010
Last updated
Feb 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME156701 FL Primary

Addresses

Primary practice location

500 Vonderburg Dr Ste 102
Brandon, FL 33511-5968

Mailing address

500 Vonderburg Dr Ste 102
Brandon, FL 33511-5968
Phone (813) 681-5658

Other practice location 1

4051 Upper Creek Dr Ste 112
Sun City Center, FL 33573-6825
Phone (813) 681-5658

Other identifiers 1

IdentifierTypeStateIssuer
114664500MedicaidFL

Other names 1

  • Angela Dawn Lucas Former name

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
I20220601003248 FL Practitioner - Family Practice 0446438113 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Florida College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Medical Care of Brandon LLCGroup PAC ID 0345233409, 16 clinicians

Practice addresses (Care Compare)

500 Vonderburg Dr
Suite 102
Brandon, FL 33511-5968
Phone (813) 681-5658

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME156701FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Medical Care of Brandon LLC CurrentSince Jan 6, 2025 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Jul 1, 2022 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Jun 1, 2022 Accepting new patients

Locations

500 Vonderburg Dr
Ste 102
Brandon, FL 33511
Phone (813) 386-2547

4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

4051 Upper Creek Dr
Ste 112
Sun City Center, FL 33573
Phone (813) 681-5658

Interoperability endpoints

  • Direct secure messaging: angela.mccarthy@hca4.eclinicaldirectplus.com
  • Direct secure messaging: angelamccarthy@cm.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1336458298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 VONDERBURG DR STE 102",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115968",
            "telephone_number": "813-681-5658",
            "fax_number": "813-681-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VONDERBURG DR STE 102",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115968",
            "telephone_number": "813-681-5658",
            "fax_number": "813-681-5250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4051 Upper Creek Dr Ste 112",
            "address_purpose": "LOCATION",
            "city": "Sun City Center",
            "state": "FL",
            "postal_code": "335736825",
            "country_code": "US",
            "telephone_number": "813-681-5658",
            "fax_number": "813-681-5250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "ANGELA",
        "middle_name": "MCCARTHY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-27",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME156701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114664500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "LUCAS",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.