Active NPI
Lukas Gladstone, D.O.
- Emergency Medicine Physician
- Amery, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 71382-21
- Practice address
- 265 Griffin St E
Amery, WI 54001-1439 - Phone
- (715) 268-8000
- NPI assigned
- Apr 7, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 65729 | MN | |
| Emergency Medicine Physician | 207P00000X | 71382-21 | WI | Primary |
Addresses
Primary practice location
265 Griffin St E
Amery, WI 54001-1439
Mailing address
1 Akron General Ave
Akron, OH 44307-2432
Phone (330) 344-6000
Other practice location 1
1 Akron General Ave
Akron, OH 44307-2432
Phone (330) 344-6000
Other practice location 2
927 Churchill St W
Stillwater, MN 55082-6605
Phone (651) 439-5330
Other practice location 3
640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-2456
Other practice location 4
535 Hospital Rd
New Richmond, WI 54017-1449
Phone (715) 243-2600
Other practice location 5
405 Stageline Rd
Hudson, WI 54016-7848
Phone (715) 531-6000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210820000904 | MI | Practitioner - Emergency Medicine | 0749560431 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Grand River Emergency Medical Group PLC
Practice addresses (Care Compare)
200 Jefferson Ave SE
Mercy Health St. Mary'S
Grand Rapids, MI 49503-4502
Phone (616) 685-5000
Hospital & facility affiliations
- Mercy Health Saint Mary'S
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65729 | MN | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand River Emergency Medical Group PLC | Emergency Medicine | Current | Accepting new patients |
| Cep America LLC | Emergency Medicine | Current | Accepting new patients |
| Cep America LLC | Emergency Medicine | Current | Accepting new patients |
Locations
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000
1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165
4599 Towne Centre Rd
Saginaw, MI 48604
Phone (989) 497-3000
Interoperability endpoints
- lgladstone2292534@direct.trinity-health.org
- lgladstone358015@direct.hfhs.org
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Grand Rapids, MI
- NPI 1114929353
Emergency Medicine, MI
Hospital & facility affiliations 1
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": "1459987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563408000000",
"number": "1679937452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 AKRON GENERAL AVE",
"city": "AKRON",
"state": "OH",
"postal_code": "443072432",
"telephone_number": "330-344-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "265 GRIFFIN ST E",
"city": "AMERY",
"state": "WI",
"postal_code": "540011439",
"telephone_number": "715-268-8000"
}
],
"practiceLocations": [
{
"address_1": "1 Akron General Ave",
"address_purpose": "LOCATION",
"city": "Akron",
"state": "OH",
"postal_code": "443072432",
"country_code": "US",
"telephone_number": "330-344-6000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "927 Churchill St W",
"address_purpose": "LOCATION",
"city": "Stillwater",
"state": "MN",
"postal_code": "550826605",
"country_code": "US",
"telephone_number": "651-439-5330",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "640 Jackson St",
"address_purpose": "LOCATION",
"city": "Saint Paul",
"state": "MN",
"postal_code": "551012502",
"country_code": "US",
"telephone_number": "651-254-2456",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "535 Hospital Rd",
"address_purpose": "LOCATION",
"city": "New Richmond",
"state": "WI",
"postal_code": "540171449",
"country_code": "US",
"telephone_number": "715-243-2600",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "405 Stageline Rd",
"address_purpose": "LOCATION",
"city": "Hudson",
"state": "WI",
"postal_code": "540167848",
"country_code": "US",
"telephone_number": "715-531-6000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GLADSTONE",
"first_name": "LUKAS",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-07",
"last_updated": "2019-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MN",
"license": "65729",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WI",
"license": "71382-21",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Amery, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; 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.