Active NPI
Robert Josef Lukavsky, M.D.
- Plastic Surgery Physician
- Philadelphia, PA
National Provider Identifier
1548506835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 01084207A
- Practice address
- 3401 N Broad St
Philadelphia, PA 19140-5103 - Phone
- (215) 707-2000
- NPI assigned
- Dec 14, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Plastic Surgery Physician | 208200000X | 01084207A | IN | Primary |
Addresses
Primary practice location
3401 N Broad St
Philadelphia, PA 19140-5103
Mailing address
709 Prospect St
Indianapolis, IN 46203-1850
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300040428 | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rlukavsky415439@eCommunityDirect.com | Community Physicians of Indiana Inc |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- rlukavsky415439@ecommunitydirect.com
- rlukavsky419875@direct.sw.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690761600000",
"number": "1548506835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 PROSPECT ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462031850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191405103",
"telephone_number": "215-707-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUKAVSKY",
"first_name": "ROBERT",
"middle_name": "JOSEF",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-12-14",
"last_updated": "2023-07-31",
"certification_date": "2023-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "IN",
"license": "01084207A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300040428",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rlukavsky415439@eCommunityDirect.com",
"affiliation": "Y",
"affiliationName": "Community Physicians of Indiana Inc",
"address_1": "8040 Clearvista Pkwy Ste 310",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462564673",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.