Individual provider Active NPI

Marie T Luksch, D.O.

  • Gynecology Physician
  • Paoli, PA
National Provider Identifier
1801183413
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
OS017675 Issued in PA
Practice address
255 W Lancaster Ave Ste 227
Paoli, PA 19301-1765
Phone
(610) 889-9550
NPI assigned
Jul 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X OS017675 PA
Student in an Organized Health Care Education/Training Program 390200000X
Gynecology Physician 207VG0400X OS017675 PA Primary

Addresses

Primary practice location

255 W Lancaster Ave Ste 227
Paoli, PA 19301-1765

Mailing address

255 W Lancaster Ave Ste 227
Paoli, PA 19301-1765

Other names 1

  • Marie T Ridenour Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20151214001547 PA Practitioner - Obstetrics/Gynecology 3577864735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Womens Health Group LLCGroup PAC ID 2961316328, 352 clinicians

Practice addresses (Care Compare)

255 W Lancaster Ave
Paoli, PA 19301-1763
Phone (610) 889-9550

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS017675PAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Womens Health Group LLC Single Specialty CurrentSince Jun 26, 2018 Accepting new patients
Regional Women's Health Group, LLC Single Specialty Past Accepting new patients
Professional Anesthesia Services of North America P.C. Single Specialty PastSince Oct 24, 2015 Accepting new patients

Locations

919 Conestoga Rd
Ste 104
Bryn Mawr, PA 19010
Phone (610) 525-6400

599 Arcola Rd
Collegeville, PA 19426
Phone (484) 565-8440

599 Arcola Rd
Ste 105
Collegeville, PA 19426
Phone (610) 525-7800

154 Exton Square Mall
Ste 105
Exton, PA 19341

855 Springdale Dr
Ste 150
Exton, PA 19341
Phone (610) 889-9550

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

255 W Lancaster Ave
Ste 227
Paoli, PA 19301
Phone (610) 889-9550

85 Old Eagle School Rd
Wayne, PA 19087
Phone (610) 688-3744

100 E Lancaster Ave
Ste 316
Wynnewood, PA 19096
Phone (610) 642-0100

Interoperability endpoints

  • Direct secure messaging: marie.luksch@axia.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1309651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1801183413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE STE 227",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE STE 227",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011765",
            "telephone_number": "610-889-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKSCH",
        "first_name": "MARIE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-03",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "OS017675",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "PA",
            "license": "OS017675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "RIDENOUR",
            "middle_name": "T",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Paoli, PA

Sources for this page

Verify at the official NPI Registry.