Individual provider Active NPI

Dragos C Luca, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Minneapolis, MN
National Provider Identifier
1417026832
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD18279 Issued in RI
Practice address
2525 Chicago Ave South
Childrens Hospitals and Clinics Pathology MPLS
Minneapolis, MN 55404
Phone
(612) 813-6280
Fax
(612) 813-6951
NPI assigned
Nov 7, 2006
Last updated
Mar 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Pathology) Physician 207ZH0000X 49092 MN
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 49092 MN
Pediatric Pathology Physician 207ZP0213X 49092 MN
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD18279 RI Primary

Addresses

Primary practice location

2525 Chicago Ave South
Childrens Hospitals and Clinics Pathology MPLS
Minneapolis, MN 55404

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541
Phone (401) 444-6779

Other practice location 1

593 Eddy Street APC 12
Providence, RI 02903
Phone (401) 444-5057

Other identifiers 1

IdentifierTypeStateIssuer
34899100MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220208001422 RI Practitioner - Pathology 8224131404 Reassigns benefits to 4 organizations
I20221207000614 MA Practitioner - Pathology 8224131404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newport HospitalGroup PAC ID 0042111437, 42 clinicians
The Miriam HospitalGroup PAC ID 6901796408, 178 clinicians
Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians

Practice addresses (Care Compare)

11 Friendship St
Newport, RI 02840-2209
Phone (401) 845-1110

164 Summit Ave
Providence, RI 02906-2853
Phone (401) 793-7245

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-3777

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49092MNMDHematology (Pathology) Physician
MD18279RIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newport Hospital Anatomic Pathology & Clinical Pathology CurrentSince May 1, 2024 Accepting new patients
Rhode Island Hospital Hematology CurrentSince May 1, 2024 Accepting new patients
Newport Hospital CurrentSince May 1, 2024 Accepting new patients
The Miriam Hospital CurrentSince May 1, 2024 Accepting new patients
The Miriam Hospital Hematology CurrentSince May 1, 2024 Accepting new patients
The Miriam Hospital Current Accepting new patients
Rhode Island Hospital CurrentSince May 1, 2024 Accepting new patients
University Pathologists Diagnostics LLC PastSince Apr 20, 2021 Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

11 Friendship St
Newport, RI 02840
Phone (401) 845-1110

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

164 Summit Ave
Ste C
Providence, RI 02906
Phone (401) 793-2931

593 Eddy St
Providence, RI 02903

593 Eddy St
#12
Providence, RI 02903
Phone (401) 444-5057

593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280

Organizations & group practices 9

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1417026832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE SOUTH",
            "address_2": "CHILDRENS HOSPITALS AND CLINICS PATHOLOGY MPLS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55404",
            "telephone_number": "612-813-6280",
            "fax_number": "612-813-6951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy Street APC 12",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "02903",
            "country_code": "US",
            "telephone_number": "401-444-5057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCA",
        "first_name": "DRAGOS",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "MN",
            "license": "49092",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MN",
            "license": "49092",
            "primary": false
        },
        {
            "code": "207ZP0213X",
            "taxonomy_group": "",
            "desc": "Pathology, Pediatric Pathology",
            "state": "MN",
            "license": "49092",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "RI",
            "license": "MD18279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34899100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.