NPIMap

Organization Active NPI

Lucas Bingham M.D., Inc.

  • Dermatology Physician
  • Ladera Ranch, CA
National Provider Identifier
1508291436
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A104512 Issued in CA
Legal business name
LUCAS BINGHAM M.D., INC.
Practice address
600 Corporate Dr Ste 100
Ladera Ranch, CA 92694
Phone
(949) 388-8022
Fax
(949) 388-8033
NPI assigned
Sep 11, 2013
Last updated
Oct 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

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

Authorized official

Name
Lucas Gardner Bingham, M.D.NPI 1295700987
Title
Dermatologist
Phone
(801) 830-7222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A104512 CA Primary

Addresses

Primary practice location

600 Corporate Dr Ste 100
Ladera Ranch, CA 92694

Mailing address

600 Corporate Dr Ste 100
Ladera Ranch, CA 92694-2107
Phone (949) 388-8022

Other practice location 1

777 Corporate Dr
Suite #150
Ladera Ranch, CA 92694-2135
Phone (949) 481-8881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140217000419 CA Part B Supplier - Clinic/Group Practice 7719116789 Receives reassigned benefits from 10 practitioners
Practice locations: Ladera Ranch, CA

National Provider Directory

National Provider Directory

Locations

600 Corporate Dr
Ste 100
Ladera Ranch, CA 92694
Phone (949) 364-3940

777 Corporate Dr
Ste 150
Ladera Ranch, CA 92694
Phone (949) 481-8881

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540252800000",
    "number": "1508291436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CORPORATE DR STE 100",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926942107",
            "telephone_number": "949-388-8022",
            "fax_number": "949-388-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CORPORATE DR STE 100",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "92694",
            "telephone_number": "949-388-8022",
            "fax_number": "949-388-8033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 Corporate Dr",
            "address_2": "Suite #150",
            "address_purpose": "LOCATION",
            "city": "Ladera Ranch",
            "state": "CA",
            "postal_code": "926942135",
            "country_code": "US",
            "telephone_number": "949-481-8881",
            "fax_number": "949-481-6666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUCAS BINGHAM M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-11",
        "last_updated": "2018-10-23",
        "status": "A",
        "authorized_official_last_name": "BINGHAM",
        "authorized_official_first_name": "LUCAS",
        "authorized_official_middle_name": "GARDNER",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "801-830-7222",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A104512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ladera Ranch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.