NPIMap

Individual provider Active NPI

Alexandria Lucas, PA-C

  • Physician Assistant
  • Stony Brook, NY
National Provider Identifier
1376161620
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
027724 Issued in NY
Practice address
101 Nicolls Rd RM 80
Stony Brook, NY 11794-3134
Phone
(631) 444-1478
NPI assigned
Jul 13, 2020
Last updated
Dec 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA2413 ME
Physician Assistant 363A00000X 027724 NY Primary

Addresses

Primary practice location

101 Nicolls Rd RM 80
Stony Brook, NY 11794-3134

Mailing address

101 Nicolls Rd RM 80
Stony Brook, NY 11794-8181
Phone (207) 807-1356

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address axl759@case.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, ME2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220121001190 NY Practitioner - Physician Assistant 4183016231 Reassigns benefits to 4 organizations
I20221027001020 ME Practitioner - Physician Assistant 4183016231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

14 Technology Dr
Suite 11
East Setauket, NY 11733-3464
Phone (631) 444-4233

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.22 of 100Reported as group
Quality
75.39
Promoting interoperability
84
Improvement activities
40
Cost
75.32

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2413MEMDPhysician Assistant
027724NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Oct 18, 2022 Accepting new patients
Mainegeneral Medical Center Physician Assistant CurrentSince Sep 27, 2022 Accepting new patients
Mainegeneral Medical Center CurrentSince Sep 27, 2022 Accepting new patients
Mainehealth CurrentSince Oct 18, 2022 Accepting new patients
Stony Brook Surgical Associates, University Faculty Practice Corporati Past Accepting new patients
University Associates in Obstetrics & Gynecology, University Faculty P Past Accepting new patients
Stony Brook Anaesthesiology, University Faculty Practice Corporation Past Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Networks

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

Interoperability endpoints

  • Direct secure messaging: alucas559413@direct.mmc.mainehealth.org

Organizations & group practices 12

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 6

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": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1376161620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD RM 80",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948181",
            "telephone_number": "207-807-1356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD RM 80",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117943134",
            "telephone_number": "631-444-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "ALEXANDRIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-13",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2413",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "axl759@case.edu",
            "affiliation": "N",
            "address_1": "9501 Euclid Ave",
            "city": "Cleveland Heights",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441064711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.