Individual provider Active NPI

Daniel S Lucky, MSN, FNP-C, GNP-C,

  • Family Nurse Practitioner
  • Modesto, CA
National Provider Identifier
1780911248
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19377 Issued in CA
Practice address
2501 McHenry Ave
Suite F
Modesto, CA 95350-3259
Phone
(209) 522-9054
NPI assigned
Nov 4, 2009
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241121003811 CA Practitioner - Nurse Practitioner 2264967660 Reassigns benefits to 2 organizations

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

LicenseStateTypeSpecialty
19377CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
American Specialty Physicians Group Inc CurrentSince Sep 1, 2024 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.