Active NPI
Peter J Lucas, MD
- Internal Medicine Physician
- Worcester, MA
National Provider Identifier
1780601260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 40857
- Practice address
- 191 May St
Worcester, MA 01602 - Phone
- (508) 368-7888
- Fax
- (508) 767-1290
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 40857 | MA | Primary |
Addresses
Primary practice location
191 May St
Worcester, MA 01602
Mailing address
630 Plantation St
Wot 12TH Floor Attn Physician Services
Worcester, MA 01605
Phone (508) 368-5529
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2053748 | Medicaid | MA | |
| 7827289 | Other | AETNA US HEALTHCARE | |
| E18010 | Other | MEDICARE B | |
| 28004 | Other | HEALTHY START | |
| 784158 | Other | MVP HEALTH CARE | |
| 4671499 | Other | CIGNA HEALTH PLAN | |
| E18010 | Other | BLUE CARE ELECT | |
| E18010 | Other | BLUE SHIELD INDEMNITY | |
| 28004 | Other | CHILDRENS MEDICAL SECURIT | |
| E18010 | Other | BLUE SHIELD HMO BLUE | |
| 0400877 | Other | EVERCARE | |
| AA1234 | Other | HARVARD PILGRIM HEALTHCAR | |
| 9900077 | Other | FALLON COMMUNITY HEALTH P | |
| 1060934 | Other | FIRST HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40857 | MA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reliant Medical Group, Inc | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780601260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 PLANTATION ST",
"address_2": "WOT 12TH FLOOR ATTN PHYSICIAN SERVICES",
"city": "WORCESTER",
"state": "MA",
"postal_code": "01605",
"telephone_number": "508-368-5529",
"fax_number": "508-368-5530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "191 MAY ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "01602",
"telephone_number": "508-368-7888",
"fax_number": "508-767-1290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCAS",
"first_name": "PETER",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "40857",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2053748",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA US HEALTHCARE",
"identifier": "7827289",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE B",
"identifier": "E18010",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHY START",
"identifier": "28004",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP HEALTH CARE",
"identifier": "784158",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTH PLAN",
"identifier": "4671499",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE ELECT",
"identifier": "E18010",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD INDEMNITY",
"identifier": "E18010",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHILDRENS MEDICAL SECURIT",
"identifier": "28004",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD HMO BLUE",
"identifier": "E18010",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EVERCARE",
"identifier": "0400877",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM HEALTHCAR",
"identifier": "AA1234",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON COMMUNITY HEALTH P",
"identifier": "9900077",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "1060934",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.