NPIMap

Individual provider Active NPI

Lucas Chacon-Lutrick, M.D.

  • Cardiovascular Disease Physician
  • Santa Fe, NM
National Provider Identifier
1629424882
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD2023-1010 Issued in NM
Practice address
1631 Hospital Dr Ste 110
Santa Fe, NM 87505-7673
Phone
(505) 984-8012
NPI assigned
May 6, 2016
Last updated
May 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD2023-1010 NM Primary
Internal Medicine Physician 207R00000X MD2023-1010 NM
Student in an Organized Health Care Education/Training Program 390200000X NM

Addresses

Primary practice location

1631 Hospital Dr Ste 110
Santa Fe, NM 87505-7673

Mailing address

MSC 10 5550 I University of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-4661

Other practice location 1

Msc 10 5550 I University Of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-4661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231102003373 NM Practitioner - Cardiovascular Disease (Cardiology) 5597036210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

1631 Hospital Dr
Suite 110
Santa Fe, NM 87505-7673
Phone (505) 984-8012

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2023-1010NMMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Hospital CurrentSince Sep 15, 2023 Accepting new patients
St Vincent Hospital Current Accepting new patients
St Vincent Hospital CurrentSince Sep 15, 2023 Accepting new patients
Southwest Medical Associates, LLC Past Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients

Locations

2237 Trinity Dr
Ste B
Los Alamos, NM 87544
Phone (505) 662-8870

1631 Hospital Dr
Ste 110
Santa Fe, NM 87505
Phone (505) 982-7246

455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1629424882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MSC 10 5550 I UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-4661",
            "fax_number": "505-272-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 HOSPITAL DR STE 110",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057673",
            "telephone_number": "505-984-8012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Msc 10 5550 I University Of New Mexico",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "505-272-4661",
            "fax_number": "505-272-4628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHACON-LUTRICK",
        "first_name": "LUCAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-06",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NM",
            "license": "MD2023-1010",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2023-1010",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.