Individual provider Active NPI

Arlene Marie Luciano, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Corona, NY
National Provider Identifier
1366208613
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
031482 Issued in NY
Practice address
3418 106TH St
Corona, NY 11368-1230
Phone
(917) 807-6199
NPI assigned
Feb 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 031482 NY Primary

Addresses

Primary practice location

3418 106TH St
Corona, NY 11368-1230

Mailing address

3418 106TH St
Corona, NY 11368-1230
Phone (917) 807-6199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250109001259 NY Practitioner - Physician Assistant 0345778080 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
031482NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Flushing Hospital Medical Center CurrentSince Dec 1, 2024 Accepting new patients
Brookview Medical Associates, PLLC CurrentSince Jan 11, 2026 Accepting new patients
TJH Medical Services, P.C. PastSince Nov 1, 2015 Accepting new patients

Locations

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

14601 45th Ave
Fl 2
Flushing, NY 11355
Phone (718) 670-5515

14601 45th Ave
Flushing, NY 11355
Phone (718) 670-5562

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 4

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": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1366208613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3418 106TH ST",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113681230",
            "telephone_number": "917-807-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3418 106TH ST",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113681230",
            "telephone_number": "917-807-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIANO",
        "first_name": "ARLENE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "031482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, NY

Sources for this page

Verify at the official NPI Registry.