Individual provider Active NPI

Judith Anne Lucas, M.D.

  • Developmental - Behavioral Pediatrics Physician
  • Albany, NY
National Provider Identifier
1457344012
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
198646 Issued in NY
Practice address
391 Myrtle Ave
Suite 3B
Albany, NY 12208
Phone
(518) 262-5401
Fax
(518) 262-4450
NPI assigned
Aug 29, 2005
Last updated
Sep 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X 198646 NY Primary

Addresses

Primary practice location

391 Myrtle Ave
Suite 3B
Albany, NY 12208

Mailing address

391 Myrtle Ave
Suite 3B
Albany, NY 12208
Phone (518) 262-5401

Other identifiers 1

IdentifierTypeStateIssuer
01585717MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20101201000136 NY Practitioner - Pediatric Medicine 4082800115 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Jul 11, 2010 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College Pediatrics CurrentSince Jun 1, 2019 Accepting new patients
Albany Medical College Pediatrics Current Accepting new patients
Albany Medical College Pediatrics CurrentSince Jul 11, 2010 Accepting new patients
Albany Medical College Current Accepting new patients

Locations

1 Clara Barton Dr
Albany, NY 12208
Phone (518) 262-5588

391 Myrtle Ave
Albany, NY 12208
Phone (518) 262-5588

391 Myrtle Ave
Ste 3B
Albany, NY 12208
Phone (518) 262-5401

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705

Interoperability endpoints

  • Direct secure messaging: jlucas26713@albanymed.direct-ci.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1457344012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 MYRTLE AVE",
            "address_2": "SUITE 3B",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12208",
            "telephone_number": "518-262-5401",
            "fax_number": "518-262-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 MYRTLE AVE",
            "address_2": "SUITE 3B",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12208",
            "telephone_number": "518-262-5401",
            "fax_number": "518-262-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "JUDITH",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-29",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NY",
            "license": "198646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01585717",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.