Active NPI
Lucas John Anderson, M.D.
- Student in an Organized Health Care Education/Training Program
- Orlando, FL
National Provider Identifier
1619728474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 2501 N Orange Ave
Orlando, FL 32804-4603 - Phone
- (407) 303-7133
- NPI assigned
- Mar 29, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
2501 N Orange Ave
Orlando, FL 32804-4603
Mailing address
2501 N Orange Ave
Orlando, FL 32804-4603
Other practice location 1
1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250602001818 | FL | Order and Referring Only - Anesthesiology | 1850800863 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750636800000",
"number": "1619728474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2501 N ORANGE AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328044603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 N ORANGE AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328044603",
"telephone_number": "407-303-7133"
}
],
"practiceLocations": [
{
"address_1": "1324 Lakeland Hills Blvd",
"address_purpose": "LOCATION",
"city": "Lakeland",
"state": "FL",
"postal_code": "338054543",
"country_code": "US",
"telephone_number": "863-687-1100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDERSON",
"first_name": "LUCAS",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-29",
"last_updated": "2025-06-23",
"certification_date": "2025-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.