Individual provider Active NPI

Lisa R. Luckey, D.O.

  • Gastroenterology Physician
  • Largo, FL
National Provider Identifier
1508008772
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
OS10452 Issued in FL
Practice address
13644 Walsingham Rd
Largo, FL 33774-3532
Phone
(727) 595-2519
Fax
(727) 631-0916
NPI assigned
Apr 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X OS10452 FL Primary

Addresses

Primary practice location

13644 Walsingham Rd
Largo, FL 33774-3532

Mailing address

2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 532-0002

Other identifiers 8

IdentifierTypeStateIssuer
2013366OtherFLCOVENTRY
21924002OtherFLWELLMED
5799464OtherFLCIGNA
119460600MedicaidFL
21924001OtherFLWELLMED
232988OtherFLUNIVERSAL
9269370OtherFLAETNA
342337OtherFLAVMED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20090803000644 FL Practitioner - GastroenterologyPractitioner - Internal Medicine 3870646201 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

13644 Walsingham Rd
Largo, FL 33774-3532
Phone (727) 216-0033

2044 Trinity Oaks Blvd
Suite 125
Trinity, FL 34655-4405
Phone (727) 372-2501

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

300 Pinellas St
Clearwater, FL 33756-3804
Phone (727) 461-8231

3231 McMullen Booth Rd
Safety Harbor, FL 34695-6607
Phone (727) 725-6526

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy63
Upper gastrointestinal (GI) endoscopy for acid reflux173

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS10452FLMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suncoast Internal Medicine Consultants, P.a. Internal Medicine CurrentSince Jul 1, 2013 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Baycare Medical Group, Inc CurrentSince Aug 1, 2023 Accepting new patients
Baycare Medical Group, Inc. Internal Medicine Current Accepting new patients

Locations

1305 S Fort Harrison Ave
Ste E
Clearwater, FL 33756
Phone (727) 631-0615

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

3131 N McMullen Booth Rd
Clearwater, FL 33761
Phone (727) 341-0551

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

13644 Walsingham Rd
Fl 2
Largo, FL 33774

13644 Washington Rd
Largo, FL 33774
Phone (727) 595-2519

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

2044 Trinity Oaks Blvd
Ste 130
Trinity, FL 34655
Phone (727) 375-0601

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: lisa.luckeydo@direct.mybaycare.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1508008772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST FL 2",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-532-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13644 WALSINGHAM RD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337743532",
            "telephone_number": "727-595-2519",
            "fax_number": "727-631-0916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKEY",
        "first_name": "LISA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-02",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "OS10452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "2013366",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED",
            "identifier": "21924002",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5799464",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119460600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED",
            "identifier": "21924001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSAL",
            "identifier": "232988",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9269370",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "342337",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.