Individual provider Active NPI

Jaclyn Marie Coletta Lucas

  • Maternal & Fetal Medicine Physician
  • New York, NY
National Provider Identifier
1477759611
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
241653 Issued in NY
Practice address
622 W 168TH St
PH 16-66
New York, NY 10032-3720
Phone
(212) 305-6293
Fax
(212) 342-2717
NPI assigned
Jun 25, 2007
Last updated
Apr 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 241653 NY Primary

Addresses

Primary practice location

622 W 168TH St
PH 16-66
New York, NY 10032-3720

Mailing address

622 W 168TH St
PH 16-66
New York, NY 10032-3720

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20120731000618 NY Practitioner - Obstetrics/Gynecology 9537325865 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustees of Columbia University in the City of New YorkGroup PAC ID 8527972546, shared by 10 NPIs, 2,262 clinicians

Practice addresses (Care Compare)

161 Fort Washington Ave
New York, NY 10032-3729
Phone (212) 305-3870

51 W 51St St
FL 3 Suite 360
New York, NY 10019-6113
Phone (212) 326-8426

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
241653NYMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Apr 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jul 1, 2012 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jul 1, 2012 Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients
Trustees of Columbia University Dept of Obstetrics and GYN Ultrasound Past Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients

Locations

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

51 W 51st St
Ste 360
New York, NY 10019
Phone (212) 326-8415

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

622 W 168th St
Ph 12
New York, NY 10032
Phone (212) 305-5819

622 W 168th St
Ph 1624
New York, NY 10032
Phone (212) 305-4098

622 W 168th St
Ph 1666
New York, NY 10032
Phone (212) 305-3751

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: jac9049@direct.nyp.org

Organizations & group practices 6

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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1477759611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "address_2": "PH 16-66",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "address_2": "PH 16-66",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-6293",
            "fax_number": "212-342-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLETTA LUCAS",
        "first_name": "JACLYN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NY",
            "license": "241653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "622 W 168th St",
            "address_2": "PH 16-66",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100323720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.