Marckenson Lucien, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9545 Issued in AZ

Practice address

151 S Oak Ave Ste 7
San Luis, AZ 85336-0756

Phone

(928) 366-5166

NPI assigned

Feb 27, 2023

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

Not listed in the public Medicare enrollment file

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Luis Walk-in Clinic IncGroup PAC ID 2668361841, shared by 12 NPIs, 49 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11823/brand/2/csg/41/fhir/r4

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.

• San Luis Walk-in Clinic, Inc.

  • Rural Health Clinic/Center
  • Somerton, AZ
  • NPI 1003991506
  NPD (past)

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1750080891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 617",
            "city": "SOMERTON",
            "state": "AZ",
            "postal_code": "853500617",
            "telephone_number": "928-315-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 S OAK AVE STE 7",
            "city": "SAN LUIS",
            "state": "AZ",
            "postal_code": "853360756",
            "telephone_number": "928-366-5166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1233 N Main St Ste 1A",
            "address_purpose": "LOCATION",
            "city": "San Luis",
            "state": "AZ",
            "postal_code": "853360663",
            "country_code": "US",
            "telephone_number": "928-550-5514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCIEN",
        "first_name": "MARCKENSON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin J. Lara, MACC, LISAC, ALPC, P
• Gregory Allen Larson, FNP-BC
• Victoria Lasala, M.D.
• David Leon, FNP-C
• Wesley William Lore, MA
• Maria Camila Macias, DPT
• Sergio I Macias, PT
• Abhinav Markus, MD
• Matt Martin
• Priscila Del Carmen Martinez Flores, EDS., NCSP

• Physician Assistant in San Luis, AZ
• Providers in San Luis, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.