Individual provider Active NPI

Jesus Lucas, M.D., PHD.

  • Family Medicine Physician
  • Honolulu, HI
National Provider Identifier
1790703197
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-22329 Issued in HI
Practice address
915 N King St
Honolulu, HI 96817-4544
Phone
(808) 848-1438
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A76832 CA
Family Medicine Physician 207Q00000X MD-22329 HI Primary

Addresses

Primary practice location

915 N King St
Honolulu, HI 96817-4544

Mailing address

1717 E Vista Chino Suite A7 # 262
Palm Springs, CA 92262
Phone (760) 774-6442

Other practice location 1

1515 N Sunrise Way
Palm Springs, CA 92262-5398
Phone (760) 778-2210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, HI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041018001272 CA Practitioner - Family PracticePractitioner - General Practice 9830159367 Reassigns benefits to 1 organization
I20240213004007 HI Practitioner - Family Practice 9830159367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kalihi Palama Health CenterGroup PAC ID 4284544842, 28 clinicians

Practice addresses (Care Compare)

915 N King St
Honolulu, HI 96817-4544
Phone (808) 848-1438

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Kalihi Palama Health Center CurrentSince Jan 30, 2024 Accepting new patients
County of Riverside CurrentSince Oct 21, 2014 Accepting new patients
County of Riverside CurrentSince Oct 21, 2014 Accepting new patients
Kalihi Palama Health Center CurrentSince Jan 30, 2024 Accepting new patients

Locations

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

4065 County Circle Dr
Rm 403
Riverside, CA 92503

915 N King St
Honolulu, HI 96817
Phone (808) 848-1438

710 N King St
Honolulu, HI 96817
Phone (808) 843-7500

Interoperability endpoints

  • Direct secure messaging: jlucas96850@direct.llu.edu
  • Direct secure messaging: jesus.lucas.1@28780.direct.athenahealth.com

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 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": "1670803200000",
    "number": "1790703197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 E VISTA CHINO SUITE A7 # 262",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "92262",
            "telephone_number": "760-774-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N KING ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968174544",
            "telephone_number": "808-848-1438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 N Sunrise Way",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922625398",
            "country_code": "US",
            "telephone_number": "760-778-2210",
            "fax_number": "760-778-2214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "JESUS",
        "credential": "M.D., PHD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A76832",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD-22329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.