Active NPI
Ericka C Luckel, P.A.
- Physician Assistant
- Bend, OR
National Provider Identifier
1851398978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA00979
- Practice address
- 2200 NE Neff Rd
Suite 200
Bend, OR 97701-4281 - Phone
- (541) 382-3344
- Fax
- (541) 382-1681
- NPI assigned
- Jul 5, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA00979 | OR | Primary |
Addresses
Primary practice location
2200 NE Neff Rd
Suite 200
Bend, OR 97701-4281
Mailing address
2041 NE Williamson CT
Ste B
Bend, OR 97701-3941
Phone (541) 382-3344
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2353 NE Conners Ave
Bend, OR 97701-6068
Phone (541) 323-7546
Hospital & facility affiliations
- St Charles Medical Center - Bend
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA00979 | OR | MD | Physician Assistant |
Organizations & group practices 1
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.
-
- Dermatology Physician
- Bend, OR
- NPI 1871954214
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Sleep Disorder Diagnostic Clinic/Center
- Bend, OR
- NPI 1164675963
Hospital
-
- General Acute Care Hospital
- Bend, OR
- NPI 1982621447
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503014400000",
"number": "1851398978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2041 NE WILLIAMSON CT",
"address_2": "STE B",
"city": "BEND",
"state": "OR",
"postal_code": "977013941",
"telephone_number": "541-382-3344",
"fax_number": "541-382-1681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 NE NEFF RD",
"address_2": "SUITE 200",
"city": "BEND",
"state": "OR",
"postal_code": "977014281",
"telephone_number": "541-382-3344",
"fax_number": "541-382-1681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCKEL",
"first_name": "ERICKA",
"middle_name": "C",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-05",
"last_updated": "2017-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OR",
"license": "PA00979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.