Juan Llusco, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

AZ31758 Issued in AZ

Practice address

1641 E Osborn Rd
Suite 3
Phoenix, AZ 85016-7146

Phone

(480) 206-7319

NPI assigned

Aug 19, 2005

Reactivated

Apr 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Pediatras Arizona

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1427152164
  NPD (past) Authorized official
• Desert Kidney Associates PLC

  • Nephrology Physician
  • Mesa, AZ
  • NPI 1144372905
  NPD (past)

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369958400000",
    "number": "1669464210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71608",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850501011",
            "telephone_number": "480-206-7319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 E OSBORN RD",
            "address_2": "SUITE 3",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167146",
            "telephone_number": "480-206-7319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLUSCO",
        "first_name": "JUAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2013-05-31",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "AZ31758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805872",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kirstin Alexis Knobbe Lloyd, M.D.
• Melissa Lloyd, MT-BC
• Robert Lloyd Jr., DO
• Lloyds Medical Services, LLC
• Vinicio Lluberes, M.D.
• LMK Surgical Services PLLC
• Lna Cna Medcial Services LLC
• Amelia Yun-Yun Lo, FNP
• Chelsie Lo, DMD
• Justin Sze-Chung Lo, D.O.

• Pediatrics Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; 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.