Individual provider Active NPI

Thomas David Lukacsa, PA-C

  • Physician Assistant
  • St Augustine, FL
National Provider Identifier
1760429906
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9104358 Issued in FL
Practice address
110 Health Park Blvd
Saint Augustine, FL 32086-5776
Phone
(904) 823-3401
Fax
(904) 829-8649
NPI assigned
May 31, 2006
Last updated
Apr 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9104358 FL Primary

Addresses

Primary practice location

110 Health Park Blvd
Saint Augustine, FL 32086-5776

Mailing address

PO Box 100237
Gainesville, FL 32610-0237
Phone (352) 392-4541

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-5776
Phone (352) 392-4541

Other practice location 2

600 E Dixie Ave
Leesburg, FL 34748-5925
Phone (352) 392-4541

Other practice location 3

70 Turin Ter
St Augustine, FL 32092-0848
Phone (904) 819-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20080523000443 FL Practitioner - Physician Assistant 5890743777 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Villages Regional Hospital Physician Services LLCGroup PAC ID 0244688893, 198 clinicians

Practice addresses (Care Compare)

10435 SE 170TH PL
Summerfield, FL 34491-8998
Phone (352) 255-3615

110 Health Park Blvd
Saint Augustine, FL 32086-5776
Phone (904) 823-3401

70 Turin Ter
Suite 100
Saint Augustine, FL 32092-0849
Phone (904) 819-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9104358FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Epn Urgent Care LLC Current Accepting new patients
Flagler Professional Health Care Services, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Quality Primary Care P a Past Accepting new patients
Kite Emergency Physicians LLC Past Accepting new patients
Guidewell Emergency Medicine Doctors, LLC PastSince Apr 6, 2025 Accepting new patients
St Luke's Emergency Care Group LLC Past Accepting new patients

Locations

6400 Davis Blvd
Ste 103
Naples, FL 34104
Phone (239) 304-0054

110 Health Park Blvd
St Augustine, FL 32086
Phone (904) 823-3401

Interoperability endpoints

  • Direct secure messaging: tlukacsa743031@direct.shands.ufl.edu

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1760429906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100237",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100237",
            "telephone_number": "352-392-4541",
            "fax_number": "352-294-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HEALTH PARK BLVD",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865776",
            "telephone_number": "904-823-3401",
            "fax_number": "904-829-8649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326105776",
            "country_code": "US",
            "telephone_number": "352-392-4541",
            "fax_number": "352-294-8519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 E Dixie Ave",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "FL",
            "postal_code": "347485925",
            "country_code": "US",
            "telephone_number": "352-392-4541",
            "fax_number": "352-294-8519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "70 Turin Ter",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320920848",
            "country_code": "US",
            "telephone_number": "904-819-7200",
            "fax_number": "904-814-8936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUKACSA",
        "first_name": "THOMAS",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.