Mark Clinton Luba, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

26967 Issued in AZ

Practice address

18555 N 79TH Ave Ste B108
Glendale, AZ 85308-8372

Phone

(888) 705-8558

Fax

(480) 776-0025

NPI assigned

Jan 20, 2006

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 2

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.lubamd.p1@direct.desertridgefp.nextgenshare.com

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.

• Archwell Health Professional Services of Arizona, LLC

  • Internal Medicine Physician
  • Mesa, AZ
  • NPI 1558026880
  Medicare reassignment NPD
• Healthy Outlook Family Medicine, PC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1023161825
  Medicare reassignment NPD
• Michael a Hart PLLC

  • Primary Care Clinic/Center
  • Peoria, AZ
  • NPI 1073162046
  NPD

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1437139813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18555 N 79TH AVE STE B108",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088372",
            "telephone_number": "888-705-8558",
            "fax_number": "480-776-0025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9750 W Peoria Ave Ste 120",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853456108",
            "country_code": "US",
            "telephone_number": "623-281-1620",
            "fax_number": "623-281-1622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUBA",
        "first_name": "MARK",
        "middle_name": "CLINTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "26967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "539869",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Z276049",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Castillanna Nicole Loya Jaffe, PA-C
• Marisa C Loya, DPT
• Crystal Lozada
• Joseph Patrick Lozon, M.D.
• Hsin-Ju Lu
• Susan T. Luberto, D.O.
• Jessica Lorraine Lucas, R-MA
• Kim L Lucas, M.D.
• Rudolph Lucas
• Kamryn Lucero, PT, DPT

• Family Medicine Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.