Individual provider Active NPI

Andrew Patrick Lucic, M.D.

  • Anesthesiology Physician
  • Cleveland, OH
National Provider Identifier
1508063124
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
35.098660 Issued in OH
Practice address
Cleveland Clinic FDTN
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone
(216) 444-2200
NPI assigned
Jun 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X TRN # 11440 FL
Anesthesiology Physician 207L00000X 35.098660 OH Primary

Addresses

Primary practice location

Cleveland Clinic FDTN
9500 Euclid Ave
Cleveland, OH 44195-0001

Mailing address

1646 Settlers Reserve Way
Westlake, OH 44145-2041
Phone (330) 322-4043

Other identifiers 2

IdentifierTypeStateIssuer
11440OtherFLTRN- TRAINING LICENSE
35.098660OtherOHSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20200424001146 CO Practitioner - Anesthesiology 2769653575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Northeastern Ohio University College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Partners of ColoradoGroup PAC ID 0345520151, 99 clinicians

Practice addresses (Care Compare)

181 W Meadow Dr
Vail, CO 81657-5078
Phone (970) 476-2451

Hospital & facility affiliations

  • Vail Health Hospital Hospital, Vail, CO, CCN 060096

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN # 11440FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: alucic152264@direct.ccf.org

Organizations & group practices 2

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 5

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": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1508063124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1646 SETTLERS RESERVE WAY",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452041",
            "telephone_number": "330-322-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CLEVELAND CLINIC FDTN",
            "address_2": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIC",
        "first_name": "ANDREW",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "TRN # 11440",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35.098660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRN- TRAINING LICENSE",
            "identifier": "11440",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "35.098660",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.