Individual provider Active NPI

Lucas Evett, PA-C

  • Physician Assistant
  • Dubuque, IA
National Provider Identifier
1497229991
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
095093 Issued in IA
Practice address
350 N Grandview Ave
Dubuque, IA 52001-6388
Phone
(563) 582-1881
NPI assigned
Jan 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 095093 IA Primary

Addresses

Primary practice location

350 N Grandview Ave
Dubuque, IA 52001-6388

Mailing address

311 6TH Ave NE
Dyersville, IA 52040-1233
Phone (815) 980-8160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190225002881 IA Practitioner - Physician Assistant 1658610316 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
095093IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Finley Hospital Physician Assistant CurrentSince Feb 18, 2019 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients

Locations

350 N Grandview Ave
Dubuque, IA 52001
Phone (563) 582-1881

Interoperability endpoints

  • Direct secure messaging: levett603075@direct.unitypoint.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1497229991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 6TH AVE NE",
            "city": "DYERSVILLE",
            "state": "IA",
            "postal_code": "520401233",
            "telephone_number": "815-980-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N GRANDVIEW AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016388",
            "telephone_number": "563-582-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVETT",
        "first_name": "LUCAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-17",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "095093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

Verify at the official NPI Registry.