Individual provider Active NPI

Marvin H Lucas, MD

  • Internal Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1508820234
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35063533L Issued in OH
Practice address
4803 Montgomery Rd Ste 120
Cincinnati, OH 45212-1153
Phone
(513) 631-2474
Fax
(513) 531-0862
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35063533L OH Primary

Addresses

Primary practice location

4803 Montgomery Rd Ste 120
Cincinnati, OH 45212-1153

Mailing address

4803 Montgomery Rd Ste 120
Cincinnati, OH 45212-1153
Phone (513) 631-2474

Other identifiers 1

IdentifierTypeStateIssuer
0987142MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlucas1792@direct.thechristhospital.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20080917000542 OH Practitioner - Internal MedicinePractitioner - Family Practice 4981771920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Cincinnati College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Christ Hospital Medical Associates, LLCGroup PAC ID 0244314102, 270 clinicians

Practice addresses (Care Compare)

4803 Montgomery Rd
Suite 120
Cincinnati, OH 45212-1153
Phone (513) 631-2474

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35063533LOHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Physicians Company, LLC Internal Medicine CurrentSince Jan 1, 2007 Accepting new patients
The Christ Hospital Medical Associates, III Internal Medicine CurrentSince Apr 4, 2022 Accepting new patients
The Christ Hospital Medical Associates, LLC Internal Medicine CurrentSince Jan 16, 2018 Accepting new patients
Waterbury Hospital Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

4803 Montgomery Rd
Ste 120
Cincinnati, OH 45212
Phone (513) 631-2474

2123 Auburn Ave
#200
Cincinnati, OH 45219
Phone (513) 321-0833

2446 Kipling Ave
Cincinnati, OH 45239
Phone (513) 583-8500

4750 E Galbraith Rd
Ste 20
Cincinnati, OH 45236
Phone (513) 686-4800

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

237 William Howard Taft Rd
#2
Cincinnati, OH 45219
Phone (513) 263-9157

4750 E Galbraith Rd
Ste 210
Cincinnati, OH 45236
Phone (513) 215-8825

4803 Montgomery Rd
Ste 207
Cincinnati, OH 45212

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

Organizations & group practices 5

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1508820234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4803 MONTGOMERY RD STE 120",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452121153",
            "telephone_number": "513-631-2474",
            "fax_number": "513-531-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4803 MONTGOMERY RD STE 120",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452121153",
            "telephone_number": "513-631-2474",
            "fax_number": "513-531-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "MARVIN",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35063533L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0987142",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlucas1792@direct.thechristhospital.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4803 Montgomery Rd Ste 120",
            "city": "Cincinnati",
            "state": "OH",
            "country_code": "US",
            "postal_code": "452121153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.