Individual provider Active NPI

Lucas P Hiller, M.D

  • Diagnostic Radiology Physician
  • San Diego, CA
National Provider Identifier
1417160474
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A91321 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(619) 543-2218
Fax
(619) 471-9473
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A91321 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081118000249 CA Practitioner - Diagnostic Radiology 0446310627 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of California, Davis School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden State Imaging Associates IncGroup PAC ID 1254761315, 242 clinicians
Renaissance Imaging Medical Associates IncGroup PAC ID 7315841756, 126 clinicians

Practice addresses (Care Compare)

1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone (818) 639-2901

3539 Ticonderoga St
San Diego, CA 92117-6011
Phone (818) 435-1433

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A91321CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Renaissance Imaging Medical Associates, Inc. Diagnostic Radiology CurrentSince Oct 24, 2025 Accepting new patients
Ellis Bandt Birkin Kollins & Wong PLLC Diagnostic Radiology CurrentSince Jan 4, 2023 Accepting new patients
Shelin Agrawal and Hyer PLLC Diagnostic Radiology CurrentSince Jan 4, 2023 Accepting new patients
Golden State Imaging Associates Inc Diagnostic Radiology CurrentSince Sep 28, 2025 Accepting new patients
Regents of the University of California Diagnostic Radiology CurrentSince Jul 1, 2008 Accepting new patients
UC San Diego Health Community Group CurrentSince Jan 12, 2019 Accepting new patients
Regents of the University of California Diagnostic Radiology CurrentSince Jul 1, 2008 Accepting new patients
Regents of the University of California Past Accepting new patients
Quantum Medical Radiology of California, P.C. Diagnostic Radiology Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

17100 Euclid St
Ste 4004
Fountain Vly, CA 92708
Phone (714) 966-7200

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

10666 N Torrey Pines Rd
Fl 2
La Jolla, CA 92037
Phone (858) 554-8122

10666 N Torrey Pines Rd
La Jolla, CA 92037
Phone (858) 554-2626

44105 15th St W
Ste 100
Lancaster, CA 93534
Phone (661) 726-6050

2400 E 4th St
National City, CA 91950
Phone (619) 470-4141

330 Lewis St
Ste 400
San Diego, CA 92103
Phone (619) 471-9250

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

16950 Via Tazon
San Diego, CA 92127
Phone (858) 521-2265

6900 N Durango Dr
Las Vegas, NV 89149
Phone (702) 380-1964

657 N Town Center Dr
Las Vegas, NV 89144
Phone (702) 233-7571

2020 Palomino Ln
Ste 100
Las Vegas, NV 89106
Phone (702) 759-8779

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

360 S Lola Ln
Pahrump, NV 89048
Phone (775) 751-7500

6500 Longley Ln
Reno, NV 89511
Phone (775) 331-7000

Organizations & group practices 10

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.

Hospital & facility affiliations 3

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1417160474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "619-543-2218",
            "fax_number": "619-471-9473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLER",
        "first_name": "LUCAS",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A91321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.