Anthony Luczak, APRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP07963 Issued in LA

Practice address

1002 12TH St
Lafayette, LA 70501-6224

Phone

(337) 534-0107

Fax

(337) 534-0184

NPI assigned

Jul 28, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: anthony.luczak@icchc.eclinicaldirectplus.com

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.

• Iberia Comprehensive Community Health Center, Inc

  dba Surrey Street Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Lafayette, LA
  • NPI 1316244338
  NPD (past)
• Iberia Comprehensive Community Health Center, Inc.

  dba Abbeville Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Abbeville, LA
  • NPI 1134166556
  NPD (past)

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1548678055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 JEFFERSON TER",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705605727",
            "telephone_number": "337-365-4945",
            "fax_number": "337-367-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 12TH ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705016224",
            "telephone_number": "337-534-0107",
            "fax_number": "337-534-0184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 Dernier St",
            "address_purpose": "LOCATION",
            "city": "Saint Martinville",
            "state": "LA",
            "postal_code": "705823809",
            "country_code": "US",
            "telephone_number": "337-342-2566",
            "fax_number": "337-342-2533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1004 Surrey St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705016143",
            "country_code": "US",
            "telephone_number": "337-456-6768",
            "fax_number": "337-456-8690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "806 Jefferson Ter",
            "address_purpose": "LOCATION",
            "city": "New Iberia",
            "state": "LA",
            "postal_code": "705605727",
            "country_code": "US",
            "telephone_number": "337-365-4945 x114",
            "fax_number": "337-367-3917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1009 Charity St",
            "address_purpose": "LOCATION",
            "city": "Abbeville",
            "state": "LA",
            "postal_code": "705105302",
            "country_code": "US",
            "telephone_number": "337-893-3443",
            "fax_number": "337-893-3439",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "298 Nolan Trace Pkwy",
            "address_purpose": "LOCATION",
            "city": "Leesville",
            "state": "LA",
            "postal_code": "71446",
            "country_code": "US",
            "telephone_number": "337-392-0110",
            "fax_number": "337-392-0111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 N Robinson St",
            "address_purpose": "LOCATION",
            "city": "Many",
            "state": "LA",
            "postal_code": "714493536",
            "country_code": "US",
            "telephone_number": "318-256-8150",
            "fax_number": "318-256-8136",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "567 Walker St",
            "address_purpose": "LOCATION",
            "city": "Merryville",
            "state": "LA",
            "postal_code": "706533040",
            "country_code": "US",
            "telephone_number": "337-825-1728",
            "fax_number": "337-825-1229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCZAK",
        "first_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-28",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "LA",
            "license": "APO7963",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "LA",
            "license": "AP07963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2374451",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandice K Lubom, MSN, APRN, PMHNP-BC
• Yvette Leblanc Lucas, LCSW
• Luci,S Troop LTC LLC
• Luci's Troop LTC LLC
• Lucy Freeman PHD LLC
• Nicole Marie Luent-Sonnier, CRNA
• Fabian Lugo, M.D.
• Maria Susana Lugo
• Erica Lukasko, O.D.
• Luke Leonards Aprn

• Pediatric Nurse Practitioner in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Pediatric Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.