Individual provider Active NPI

Lulita Lucero-Ugalino, MD

  • Family Medicine Physician
  • Waldorf, MD
National Provider Identifier
1841452687
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD2011-0511 Issued in NM
Practice address
6B Industrial Park Drive
Unit 8
Waldorf, MD 20735-2073
Phone
(301) 337-1219
Fax
(888) 472-0377
NPI assigned
Jul 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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 MD2011-0511 NM Primary

Addresses

Primary practice location

6B Industrial Park Drive
Unit 8
Waldorf, MD 20735-2073

Mailing address

7210 Flame Leaf CT
Clinton, MD 20735-4093
Phone (301) 337-1219

Other practice location 1

701 W 5th St
Odessa, TX 79763-4206
Phone (432) 335-5333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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
I20141007000214 MD Practitioner - Family PracticePractitioner - Internal MedicinePractitioner - Hospitalist 7113184995 Reassigns benefits to 2 organizations
I20141007000462 DC Practitioner - HospitalistPractitioner - Family PracticePractitioner - Internal Medicine 7113184995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Saint Louis University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mdics at Civista LLCGroup PAC ID 8325200793, 35 clinicians

Practice addresses (Care Compare)

5 Garrett Ave
La Plata, MD 20646-5960
Phone (443) 949-0814

6 B Industrial Park Dr
Unit 8
Waldorf, MD 20602-2707
Phone (301) 337-1219

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mdics at Civista LLC CurrentSince May 1, 2016 Accepting new patients
Prime Medical Health Center, Inc Family Medicine CurrentSince Feb 7, 2019 Accepting new patients
Usacs Integrated Acute Care Services of Maryland, LLC CurrentSince Feb 23, 2023 Accepting new patients
Civista Medical Center Inc Past Accepting new patients

Locations

11711 Livingston Rd
Ft Washington, MD 20744
Phone (301) 203-2250

5 Garrett Ave
La Plata, MD 20646
Phone (301) 609-4000

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

3261 Old Washington Rd
Ste 3010
Waldorf, MD 20602
Phone (301) 645-9551

6 Industrial Park Dr
Ste B
Waldorf, MD 20602
Phone (301) 337-1219

Interoperability endpoints

  • Direct secure messaging: llucerougalino548044@direct.umm.edu

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.

Hospital & facility affiliations 4

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": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1841452687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7210 FLAME LEAF CT",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207354093",
            "telephone_number": "301-337-1219",
            "fax_number": "888-472-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6B INDUSTRIAL PARK DRIVE",
            "address_2": "UNIT 8",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "207352073",
            "telephone_number": "301-337-1219",
            "fax_number": "888-472-0377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 W 5th St",
            "address_purpose": "LOCATION",
            "city": "Odessa",
            "state": "TX",
            "postal_code": "797634206",
            "country_code": "US",
            "telephone_number": "432-335-5333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCERO-UGALINO",
        "first_name": "LULITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2011-0511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.