Individual provider Active NPI

Mary Edith Lucci, CRNA

  • Certified Registered Nurse Anesthetist
  • Brockton, MA
National Provider Identifier
1801872023
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA-00184 Issued in OH
Practice address
235 N Pearl St
Brockton, MA 02301-1794
Phone
(508) 427-3000
NPI assigned
Dec 20, 2005
Last updated
Mar 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NA-00184 OH Primary

Addresses

Primary practice location

235 N Pearl St
Brockton, MA 02301-1794

Mailing address

960 Massachusetts Ave Ste 2
Boston, MA 02118-2690
Phone (617) 414-5405

Other practice location 1

9500 Euclid Ave
Cleveland, OH 44195-4701
Phone (216) 444-2200

Other identifiers 2

IdentifierTypeStateIssuer
P00949833OtherOHMEDICARE RAILROAD
0157682MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140908001355 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709854755 Reassigns benefits to 2 organizations
I20151106001495 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709854755 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
NA-00184OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 30, 2018 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2023 Accepting new patients
Lake Erie Sedation Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince May 11, 2023 Accepting new patients
Steward Medical Group, Inc CurrentSince Nov 30, 2018 Accepting new patients
Grant Anesthesia Services LTD Past Accepting new patients
Anesthesiology Consultants of Toledo, Inc Past Accepting new patients
Bel-Park Anesthesia Associates, Inc. Nurse Anesthetist, Certified Registered PastSince Jun 28, 2020 Accepting new patients
The Endoscopy Center at Bainbridge LLC PastSince Apr 1, 2020 Accepting new patients

Locations

138 Haverhill St
Andover, MA 01810
Phone (978) 296-2302

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

795 Middle St
Fall River, MA 02721
Phone (508) 235-5046

907 Sumner St
Ste M201
Stoughton, MA 02072

8185 Washington St
Ste 6
Chagrin Falls, OH 44023
Phone (440) 708-0582

75 Sylvania Dr
Dayton, OH 45440
Phone (937) 320-5050

9000 N Main St
Ste 405
Englewood, OH 45415
Phone (937) 320-5050

1611 S Green Rd
Ste 120
South Euclid, OH 44121
Phone (440) 708-0582

Organizations & group practices 8

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1801872023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE STE 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690",
            "telephone_number": "617-414-5405",
            "fax_number": "617-789-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 N PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011794",
            "telephone_number": "508-427-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9500 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441954701",
            "country_code": "US",
            "telephone_number": "216-444-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCCI",
        "first_name": "MARY",
        "middle_name": "EDITH",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-20",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "NA-00184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00949833",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0157682",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.