Roger S Luckmann, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

59996 Issued in MA

Practice address

55 Lake Ave N
Department of Family Medicine
Worcester, MA 01655-0002

Phone

(508) 856-2818

NPI assigned

Nov 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1133049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239148800000",
    "number": "1386627057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "address_2": "DEPARTMENT OF FAMILY MEDICINE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-856-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKMANN",
        "first_name": "ROGER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-27",
        "last_updated": "2009-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "59996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3045064",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Lucente, M.D.
• Evan S Lucey
• Haley Lucier
• Matthew Lucier
• Nadine Luck, PHARMD
• Vikki Ludwigson, MSW
• Kory Ludy, LMHC
• Mary L Ludy, LMHC,LMFT
• Stephen Ludy, CADC, LADC
• Cara Lugo

• Family Medicine Physician in Worcester, MA
• Providers in Worcester, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.