Lucas W Konovalenko, MD

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

A135704 Issued in CA

Practice address

935 Trancas St Ste 4B
Napa, CA 94558-2943

Phone

(707) 346-4444

Fax

(877) 354-4771

NPI assigned

Jul 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Lucas W Campos Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Integrated Pain Management Medical Group, Inc.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Walnut Creek, CA
  • NPI 1922198779
  Medicare reassignment NPD
• Summit Pain Alliance Inc

  • Specialist
  • Santa Rosa, CA
  • NPI 1558630020
  Medicare reassignment NPD
• Summit Pain Alliance Inc

  • Specialist
  • Petaluma, CA
  • NPI 1538559018
  NPD
• California Pacific Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1275002453
  NPD (past)

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1699972679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 TRANCAS ST STE 4B",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945582943",
            "telephone_number": "707-346-4444",
            "fax_number": "877-354-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 TRANCAS ST STE 4B",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945582943",
            "telephone_number": "707-346-4444",
            "fax_number": "877-354-4771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONOVALENKO",
        "first_name": "LUCAS",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301089987",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A135704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "0412253",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUCAS",
            "last_name": "CAMPOS",
            "middle_name": "W",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William Alan Kocsis, MD
• Donald Koelpin, PHD
• Aliya Khan Kohler, M.D.
• Shoko Kokubun, PHD
• Karlyne Michelle Konczal
• Melissa Koonce, LVN
• Eric Kopf, MD
• Nataliya K Kopilow, CMT
• Mitchell Ted Koufos, M.A.
• Kelly Krainas

• Pain Medicine (Anesthesiology) Physician in Napa, CA
• Providers in Napa, CA by specialty
• Pain Medicine (Anesthesiology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.