Active NPI
Donald W. Lucek, MD
- Surgery Physician
- Mobridge, SD
National Provider Identifier
1689659427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 4036
- Practice address
- 1309 10TH Ave W
Mobridge, SD 57601-1146 - Phone
- (605) 845-8170
- NPI assigned
- Dec 14, 2005
- Last updated
- Jan 28, 2021
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 4036 | SD | Primary |
| Surgery Physician | 208600000X | 42530 | MN | |
| Surgery Physician | 208600000X | 51171 | WI |
Addresses
Primary practice location
1309 10TH Ave W
Mobridge, SD 57601-1146
Mailing address
1309 10TH Ave W
Mobridge, SD 57601-1146
Phone (605) 845-8170
Other practice location 1
325 Butts Avenue
Tomah, WI 54660-1412
Phone (608) 372-5951
Other practice location 2
325 Butts Avenue
Tomah, WI 54660-1412
Phone (608) 372-5951
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 021M4LU, 070L6LU | Other | MN | BCBS |
| 363606405 | Other | MN | SVHP |
| 020050950 | Other | MN | MEDICARE - RAILROAD |
| 1700792, 3909161 | Other | MN | MEDICA |
| 363606405 | Other | MN | CHAMPUS |
| 611829100 | Medicaid | MN | |
| NA9501023797 | Other | MN | PREFERRED ONE |
| 127977 | Other | MN | MNCARE-U |
| 021M4LU | Other | MN | MNCARE |
| HP30630 | Other | MN | HEALTH PARTNERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4036 | SD | MD | Pharmacist |
| 51171 | WI | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611792000000",
"number": "1689659427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1309 10TH AVE W",
"city": "MOBRIDGE",
"state": "SD",
"postal_code": "576011146",
"telephone_number": "605-845-8170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1309 10TH AVE W",
"city": "MOBRIDGE",
"state": "SD",
"postal_code": "576011146",
"telephone_number": "605-845-8170"
}
],
"practiceLocations": [
{
"address_1": "325 Butts Avenue",
"address_purpose": "LOCATION",
"city": "Tomah",
"state": "WI",
"postal_code": "546601412",
"country_code": "US",
"telephone_number": "608-372-5951",
"fax_number": "507-837-4280",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "325 Butts Avenue",
"address_purpose": "LOCATION",
"city": "Tomah",
"state": "WI",
"postal_code": "546601412",
"country_code": "US",
"telephone_number": "608-372-5951",
"fax_number": "507-837-4280",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LUCEK",
"first_name": "DONALD",
"middle_name": "W.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-14",
"last_updated": "2021-01-28",
"certification_date": "2021-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "SD",
"license": "4036",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MN",
"license": "42530",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "51171",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "021M4LU, 070L6LU",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SVHP",
"identifier": "363606405",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE - RAILROAD",
"identifier": "020050950",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "1700792, 3909161",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "363606405",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "611829100",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "NA9501023797",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MNCARE-U",
"identifier": "127977",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MNCARE",
"identifier": "021M4LU",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP30630",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mobridge, SD
- Faith Antoinette Laroche, NAACT
- Jenny Marie Larson, LPC
- Holly V Lashmet, CRNA
- Janet Marie Lassen, LCSW
- David-Rush Douglas Lowe, MEDICAL TECHNOLOGIST
- Robert C Marciano, DO
- McClellan-Swanson Dental Clinc, Inc.
- Marc Herbert McClellan, D.D.S.
- Mobridge Regional Hospital (Mobridge Regional Hospital Community Health Worker)
- Mobridge Regional Hospital (Swingbed)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.