Paul A Lucky, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

35049616 Issued in OH

Practice address

10506 Montgomery Rd Ste 402
Cincinnati, OH 45242-4489

Phone

(513) 791-6161

Fax

(513) 791-4085

NPI assigned

Mar 8, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Dermatology

Education

Yale University School of Medicine, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatologists of Southwestern Ohio, LLCGroup PAC ID 7113973041, 116 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

99.15 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Procedures performed for Medicare patients

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.

• Dermatologists of Southwestern Ohio, LLC.

  dba Dermatologists of Southwest Ohio, LLC

  • Dermatology Physician
  • Dayton, OH
  • NPI 1801819883
  Medicare reassignment Care Compare group NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496880000000",
    "number": "1720119068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 FAR HILLS AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292381",
            "telephone_number": "937-433-7536",
            "fax_number": "937-433-9612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10506 MONTGOMERY RD STE 402",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452424489",
            "telephone_number": "513-791-6161",
            "fax_number": "513-791-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKY",
        "first_name": "PAUL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2017-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35049616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0538912",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chasity Luckey
• Jonesha Luckey
• Sara Luckhaupt, MD
• Maria Lucking
• Anne W Lucky, M.D.
• Lucy Lu's Transportation Services, Inc.
• Nicole Sheree Luddington, MD
• Deandrea Ludlow
• Sarah Wallace Ludvigsen
• Chyi Luebbe

• Dermatology Physician in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2017; 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.