Individual provider Active NPI

Stephanie Joanne Luca, PA

  • Physician Assistant
  • Holbrook, NY
National Provider Identifier
1952844136
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020384 Issued in NY
Practice address
203 Union Ave
Holbrook, NY 11741-1704
Phone
(631) 585-5858
Fax
(631) 585-6362
NPI assigned
Nov 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 020384 NY Primary

Addresses

Primary practice location

203 Union Ave
Holbrook, NY 11741-1704

Mailing address

203 Union Ave
Holbrook, NY 11741-1704
Phone (631) 585-5858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220429000440 HI Practitioner - Physician Assistant 1456748045 Reassigns benefits to 4 organizations
I20231106001282 NY Practitioner - Physician Assistant 1456748045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hawaii Permanente Medical Group IncGroup PAC ID 7618880667, 705 clinicians

Practice addresses (Care Compare)

55 Maui Lani Pkwy
Wailuku, HI 96793-2416
Phone (808) 243-6050

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
82.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Permanente Medical Group Inc CurrentSince Jan 18, 2026 Accepting new patients
Kau Hospital CurrentSince Dec 1, 2023 Accepting new patients
Kau Hospital CurrentSince Dec 1, 2023 Accepting new patients

Locations

55 Maui Lani Pkwy
Wailuku, HI 96793
Phone (808) 243-6000

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1952844136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 UNION AVE",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411704",
            "telephone_number": "631-585-5858",
            "fax_number": "631-585-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 UNION AVE",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411704",
            "telephone_number": "631-585-5858",
            "fax_number": "631-585-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCA",
        "first_name": "STEPHANIE",
        "middle_name": "JOANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

Verify at the official NPI Registry.