Individual provider Active NPI

Jon Lucaj, MD

  • Anesthesiology Physician
  • Portland, OR
National Provider Identifier
1922591296
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD214193 Issued in OR
Practice address
707 SW Washington St Ste 700
Portland, OR 97205-3523
Phone
(503) 299-9906
Fax
(503) 225-9002
NPI assigned
Jun 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 75098 MN
Surgery Physician 208600000X 4301115638 MI
Anesthesiology Physician 207L00000X MD214193 OR Primary

Addresses

Primary practice location

707 SW Washington St Ste 700
Portland, OR 97205-3523

Mailing address

PO Box 35147
Seattle, WA 98124-5147

Other practice location 1

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-8407

Other practice location 2

44405 Woodward Ave
Pontiac, MI 48341-5023
Phone (248) 858-3234

Other practice location 3

200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240826003590 OR Practitioner - Anesthesiology 0547516676 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oregon Anesthesiology Group PCGroup PAC ID 3476451659, 239 clinicians
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 299-9906

9205 SW Barnes Rd
Portland, OR 97225-6603
Phone (503) 216-1234

Hospital & facility affiliations

  • Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Dec 1, 2024 Accepting new patients
Legacy Clinics LLC CurrentSince Aug 12, 2024 Accepting new patients
Legacy Clinics LLC CurrentSince Aug 12, 2024 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Dec 1, 2024 Accepting new patients
Oregon Anesthesiology Group PC Anesthesiology CurrentSince Nov 4, 2024 Accepting new patients
Providence Health & Services - Oregon Anesthesiology CurrentSince Dec 1, 2024 Accepting new patients
Providence Health & Services - Oregon Anesthesiology CurrentSince Dec 1, 2024 Accepting new patients
Mayo Clinic Current Accepting new patients
Oag Trauma Services LLC Anesthesiology PastSince Jun 23, 2024 Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

707 SW Washington St
Ste 700
Portland, OR 97205

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

Interoperability endpoints

  • Direct secure messaging: jon.lucaj.1@11987.direct.athenahealth.com

Organizations & group practices 10

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 5

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": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1922591296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35147",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981245147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SW WASHINGTON ST STE 700",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972053523",
            "telephone_number": "503-299-9906",
            "fax_number": "503-225-9002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 N Gantenbein Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271623",
            "country_code": "US",
            "telephone_number": "503-413-8407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44405 Woodward Ave",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483415023",
            "country_code": "US",
            "telephone_number": "248-858-3234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCAJ",
        "first_name": "JON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-12",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "75098",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301115638",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD214193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.