Active NPI
Daniel S Lucky, MSN, FNP-C, GNP-C,
- Family Nurse Practitioner
- Modesto, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 19377
- Practice address
- 2501 McHenry Ave
Suite F
Modesto, CA 95350-3259 - Phone
- (209) 522-9054
- NPI assigned
- Nov 4, 2009
- Last updated
- Sep 22, 2026
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 19377 | CA | Primary |
Addresses
Primary practice location
2501 McHenry Ave
Suite F
Modesto, CA 95350-3259
Mailing address
201 E Rumble Rd Ste E
Modesto, CA 95350-2356
Phone (209) 527-7777
Other practice location 1
18144 Seco St
Jamestown, CA 95327-9498
Phone (209) 984-4820
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
173 E Webster St
Colusa, CA 95932-2949
Phone (209) 287-6308
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19377 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Specialty Physicians Group Inc | Current | Accepting new patients | |
| Aspen Family Medical Group of Modesto Inc. | Past | Accepting new patients | |
| Aspen Family Medical Group of Modesto, Inc. | Past | Accepting new patients |
Locations
151 E Webster St
Ste B
Colusa, CA 95932
Phone (209) 287-6308
700 17th St
Ste 205
Modesto, CA 95354
Phone (209) 248-7851
Interoperability endpoints
- dlucky581408@hisp.ehr.sutterhealth.org
Organizations & group practices 4
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.
-
- Emergency Medicine Physician
- Modesto, CA
- NPI 1568992923
-
dba Advantage Wound Care
- Surgery Physician
- El Segundo, CA
- NPI 1083883938
-
dba Aspen Family Medical Group
- Non-Pharmacy Dispensing Site
- Modesto, CA
- NPI 1457779043
-
dba Premium Mental Health Services
- Family Medicine Physician
- Modesto, CA
- NPI 1467533737
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Memorial Medical Center
- General Acute Care Hospital
- Modesto, CA
- NPI 1699129601
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790035200000",
"number": "1780911248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 E RUMBLE RD STE E",
"city": "MODESTO",
"state": "CA",
"postal_code": "953502356",
"telephone_number": "209-527-7777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 MCHENRY AVE",
"address_2": "SUITE F",
"city": "MODESTO",
"state": "CA",
"postal_code": "953503259",
"telephone_number": "209-522-9054"
}
],
"practiceLocations": [
{
"address_1": "18144 Seco St",
"address_purpose": "LOCATION",
"city": "Jamestown",
"state": "CA",
"postal_code": "953279498",
"country_code": "US",
"telephone_number": "209-984-4820",
"fax_number": "209-984-4825",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LUCKY",
"first_name": "DANIEL",
"middle_name": "S",
"credential": "MSN, FNP-C, GNP-C,",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-11-04",
"last_updated": "2026-09-22",
"certification_date": "2026-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "19377",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; 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.