Individual provider Active NPI

Patrick Daniel Lucey, DO

  • Emergency Medicine Physician
  • Trenton, MI
National Provider Identifier
1417799792
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5151016879 Issued in MI
Practice address
5450 Fort St
Trenton, MI 48183-4601
Phone
(734) 671-3297
NPI assigned
Jun 10, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5151016879 MI Primary

Addresses

Primary practice location

5450 Fort St
Trenton, MI 48183-4601

Mailing address

5450 Fort St
Trenton, MI 48183-4601
Phone (734) 671-3297

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240620001005 MI Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 1759824659

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5151016879MIMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1417799792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 FORT ST",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481834601",
            "telephone_number": "734-671-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 FORT ST",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481834601",
            "telephone_number": "734-671-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCEY",
        "first_name": "PATRICK",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5151016879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, MI

Sources for this page

Verify at the official NPI Registry.