Jeremy Tyler Luczak, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11426 Issued in AZ

Practice address

5151 E Broadway Rd Ste 107
Mesa, AZ 85206-1346

Phone

(480) 290-7000

Fax

(602) 254-6840

NPI assigned

Jun 3, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pulmonary Associates PAGroup PAC ID 6406842558, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19484/brand/1/csg/1/fhir/r4
• Direct secure messaging: jeremy.luczak.1@19484.direct.athenahealth.com

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.

• Pulmonary Associates, PA

  • Pulmonary Disease Physician
  • Mesa, AZ
  • NPI 1497854269
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1699516013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 E BROADWAY RD STE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061346",
            "telephone_number": "480-290-7000",
            "fax_number": "602-254-6840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 E BROADWAY RD STE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061346",
            "telephone_number": "480-290-7000",
            "fax_number": "602-254-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCZAK",
        "first_name": "JEREMY",
        "middle_name": "TYLER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-03",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "11426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Elizabeth Lucero
• Michael J Lucherini, MD MS
• Carmen Lynne Lucia, PSYD
• Francis Rahul Luciano, PA
• Julienne Lucius
• Kerstyn Ludlow, LAMFT
• Anthony L (NMN) Ludwig, LPC
• Wade Christian Lueck, PH.D.
• Henry Luedy, M.D.
• Randi Renee Luevano, LCSW

• Physician Assistant in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; 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.

Verify at the official NPI Registry.