NPIMap

Individual provider Active NPI

Irene Diane Lucas, MD

  • Family Medicine Physician
  • Mountain Top, PA
National Provider Identifier
1831181270
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD0339709 Issued in PA
Practice address
62 N Mountain Blvd
Mountain Top, PA 18707-1117
Phone
(570) 474-6562
Fax
(570) 474-0796
NPI assigned
Aug 22, 2005
Last updated
Jul 12, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD0339709 PA Primary

Addresses

Primary practice location

62 N Mountain Blvd
Mountain Top, PA 18707-1117

Mailing address

62 N Mountain Blvd
Mountain Top, PA 18707-1117
Phone (570) 474-6562

Other identifiers 1

IdentifierTypeStateIssuer
0010752110001MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101025000270 PA Practitioner - Family Practice 8022201938 Practice locations: Mountain Top, PA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

506 Hazle St
Wilkes Barre, PA 18702-4646
Phone (570) 270-4366

62 N Mountain Blvd
Mountain Top, PA 18707-1117
Phone (570) 474-6562

62 N Mountain Blvd
Mountain Top, PA 18707-1168

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0339709PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Irene Lucas M.D. Family Medicine PastSince Sep 25, 1985 Accepting new patients

Organizations & group practices 2

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 61

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

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1831181270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 N MOUNTAIN BLVD",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187071117",
            "telephone_number": "570-474-6562",
            "fax_number": "570-474-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 N MOUNTAIN BLVD",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187071117",
            "telephone_number": "570-474-6562",
            "fax_number": "570-474-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "IRENE",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD0339709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010752110001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Top, PA

Sources for this page

Verify at the official NPI Registry.