Lukasz Urban, PSYD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PSY30225 Issued in CA

Practice address

5252 Balboa Ave Ste 1004
San Diego, CA 92117

Phone

(619) 314-5560

NPI assigned

Aug 16, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sailor Health Medical PAGroup PAC ID 4486182342, 301 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sailor Health Medical PA

  • Psychologist
  • Coral Gables, FL
  • NPI 1841012960

  IL

  Medicare reassignment Care Compare group NPD
• Sailor Health Medical of California, P.C.

  • Psychologist
  • Miami, FL
  • NPI 1013879436

  CA

  Medicare reassignment
• San Diego Psychology & Telehealth

  • Adolescent and Children Mental Health Clinic/Center
  • San Diego, CA
  • NPI 1316417009
  NPD (past) Authorized official
• Darrell Broaddus Psychological Services PC

  • Clinical Psychologist
  • Orangevale, CA
  • NPI 1215339650
  NPD (past)

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1619256039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5252 BALBOA AVE STE 1004",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176986",
            "telephone_number": "619-314-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5252 BALBOA AVE STE 1004",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92117",
            "telephone_number": "619-314-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBAN",
        "first_name": "LUKASZ",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-16",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY30225",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY30225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGY LICENSE",
            "identifier": "PSY30225",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYEE ID NUMBER",
            "identifier": "83-1489014",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Urban Eyewear Inc
• Urban Medical Equipment
• Urban Optiks Optometry, Inc
• Urban Restoration Counseling Center
• Urban Restoration Counseling Center
• Claudinne Magno Urbanavage, BSN, RN
• Christopher Edward Urband, MD
• Lindsey Starr Urband, M.D.
• Douglas Andrew Urbaniak, IDC
• Marisa Urbano-Sedlund

• Clinical Child & Adolescent Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Child & Adolescent Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.