Individual provider Active NPI

Lucas Aaron McDuffie, M.D.

  • Pediatric Surgery Physician
  • Charleston, SC
National Provider Identifier
1710269261
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
MD214949 Issued in OR
Practice address
171 Ashley Ave
Charleston, SC 29425-5112
Phone
(843) 792-1414
NPI assigned
Sep 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X MD214949 OR Primary
Pediatric Surgery Physician 2086S0120X 84076 SC

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-5112

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, OR, AZ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20201001000470 SC Practitioner - General SurgeryPractitioner - Other (Physician) 6709024920 Reassigns benefits to 1 organization
I20230706001558 OR Practitioner - General Surgery 6709024920 Reassigns benefits to 4 organizations
I20250310002035 AZ Practitioner - General SurgeryPractitioner - Pediatric Medicine 6709024920 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center CurrentSince Jul 6, 2023 Accepting new patients
Providence Health & Services - Oregon Family Medicine CurrentSince Jan 1, 2024 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Jul 6, 2023 Accepting new patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince Aug 1, 2023 Accepting new patients
Banner-University Medical Group Family Medicine Current Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Banner-University Medical Group CurrentSince Mar 1, 2025 Accepting new patients
Banner-University Medical Group CurrentSince Mar 1, 2025 Accepting new patients
University Professional Services CurrentSince Aug 1, 2023 Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 1, 2024 Accepting new patients
University Medical Associates of the Medical University of South Carol Family Medicine CurrentSince Sep 10, 2020 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Sep 10, 2020 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 1, 2024 Accepting new patients
Oregon Health & Science University Past Accepting new patients
Shriners Hospitals for Children Past Accepting new patients

Locations

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

1625 N Campbell Ave
Tucson, AZ 85719

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

9135 SW Barnes Rd
Ste 763
Portland, OR 97225
Phone (503) 216-6050

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

501 N Graham St
Ste 300
Portland, OR 97227
Phone (503) 413-4300

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Interoperability endpoints

  • Direct secure messaging: lmcduffie22333@direct.ohsu.edu

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1315699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1710269261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294255112",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDUFFIE",
        "first_name": "LUCAS",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-11",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "OR",
            "license": "MD214949",
            "primary": true
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "SC",
            "license": "84076",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.