Individual provider Active NPI

Jennifer B. Lucas, M.D.

  • Specialist
  • Greenbrae, CA
National Provider Identifier
1619078979
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A62799 Issued in CA
Practice address
1350 S Eliseo Dr
Suite 200
Greenbrae, CA 94904-2011
Phone
(415) 925-5000
Fax
(415) 925-5050
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A62799 CA Primary

Addresses

Primary practice location

1350 S Eliseo Dr
Suite 200
Greenbrae, CA 94904-2011

Mailing address

1350 S Eliseo Dr
Suite 200
Greenbrae, CA 94904-2011
Phone (415) 925-5000

Other identifiers 2

IdentifierTypeStateIssuer
A62799OtherCASTATE LICENSE
00A627990MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081205000095 CA Practitioner - Medical OncologyPractitioner - Hematology 1052472388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Hematology
Education
Georgetown University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Marin Cancer Care, Inc.Group PAC ID 1557542289, 13 clinicians

Practice addresses (Care Compare)

1350 S Eliseo Dr
Suite 200
Greenbrae, CA 94904-2018
Phone (415) 925-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A62799CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Marin Cancer Care Inc CurrentSince Dec 4, 2010 Accepting new patients

Locations

1350 S Eliseo Dr
Ste 200
Greenbrae, CA 94904
Phone (415) 925-5000

651 1st St W
Ste L
Sonoma, CA 95476
Phone (707) 935-5189

Interoperability endpoints

  • Direct secure messaging: jlucas36790@hisp.ehr.sutterhealth.org

Organizations & group practices 1

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 4

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619078979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 S ELISEO DR",
            "address_2": "SUITE 200",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042011",
            "telephone_number": "415-925-5000",
            "fax_number": "415-925-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S ELISEO DR",
            "address_2": "SUITE 200",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042011",
            "telephone_number": "415-925-5000",
            "fax_number": "415-925-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "JENNIFER",
        "middle_name": "B.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A62799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A62799",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A627990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbrae, CA

Sources for this page

Verify at the official NPI Registry.