Active NPI
Lucas Golub
- Internal Medicine Physician
- Atlanta, GA
National Provider Identifier
1467710848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 074186
- Practice address
- 1900 Perry Blvd NW
Atlanta, GA 30318-3500 - Phone
- (470) 890-0900
- NPI assigned
- Apr 24, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2019-02563 | NC | |
| Internal Medicine Physician | 207R00000X | 074186 | GA | Primary |
Addresses
Primary practice location
1900 Perry Blvd NW
Atlanta, GA 30318-3500
Mailing address
12900 Park Plaza Dr Ste 150
Cerritos, CA 90703-9329
Phone (562) 977-4639
Other practice location 1
104 River Hills Rd Ste D
Asheville, NC 28805-2545
Phone (866) 544-7122
Other practice location 2
1530 E Euclid Ave
Des Moines, IA 50313-4726
Phone (562) 977-4639
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Matter Health of Georgia, LLC | Internal Medicine | Current | Accepting new patients |
Locations
1265 Lakewood Ave SE
Atlanta, GA 30315
Interoperability endpoints
- lucas.golub.2@22414.direct.athenahealth.com
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Atlanta, GA
- NPI 1770230997
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714953600000",
"number": "1467710848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12900 PARK PLAZA DR STE 150",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907039329",
"telephone_number": "562-977-4639",
"fax_number": "714-741-4479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 PERRY BLVD NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303183500",
"telephone_number": "470-890-0900"
}
],
"practiceLocations": [
{
"address_1": "104 River Hills Rd Ste D",
"address_purpose": "LOCATION",
"city": "Asheville",
"state": "NC",
"postal_code": "288052545",
"country_code": "US",
"telephone_number": "866-544-7122",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1530 E Euclid Ave",
"address_purpose": "LOCATION",
"city": "Des Moines",
"state": "IA",
"postal_code": "503134726",
"country_code": "US",
"telephone_number": "562-977-4639",
"fax_number": "714-741-4479",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOLUB",
"first_name": "LUCAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-24",
"last_updated": "2024-05-06",
"certification_date": "2024-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "2019-02563",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "074186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.