NPIMap

Individual provider Active NPI

Jenna Luczka, PA-C

  • Family Medicine Physician
  • Smithfield, PA
National Provider Identifier
1972147874
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MA061182 Issued in PA
Practice address
100 Ridgeview Dr
Smithfield, PA 15478-1650
Phone
(724) 569-8100
NPI assigned
Nov 4, 2019
Last updated
Sep 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Transplant Hepatology Physician 2080T0004X MA061182 PA
Family Medicine Physician 207Q00000X MA061182 PA Primary

Addresses

Primary practice location

100 Ridgeview Dr
Smithfield, PA 15478-1650

Mailing address

2006 Revere Dr
Connellsville, PA 15425-1523
Phone (724) 322-3957

Other practice location 1

4401 Penn Ave
Pittsburgh, PA 15224-1334
Phone (412) 692-5325

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jluczka@MMI-PA.direct.office.nextgen.com Direct

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
I20200116002319 PA Practitioner - Physician Assistant 9638504863 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Montgomery Medical IncGroup PAC ID 1355588542, 11 clinicians

Practice addresses (Care Compare)

105 Laurel View Dr
Smithfield, PA 15478-8908
Phone 7245698100206

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA061182PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Dec 4, 2019 Accepting new patients
University of Pittsburgh Physicians CurrentSince Dec 4, 2019 Accepting new patients

Locations

300 Halket St
Ste 5200
Pittsburgh, PA 15213
Phone (412) 641-7850

4401 Penn Ave
Pittsburgh, PA 15224
Phone (412) 692-5030

Interoperability endpoints

  • Direct secure messaging: jluczka@mmi-pa.direct.office.nextgen.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1972147874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 REVERE DR",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154251523",
            "telephone_number": "724-322-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RIDGEVIEW DR",
            "city": "SMITHFIELD",
            "state": "PA",
            "postal_code": "154781650",
            "telephone_number": "724-569-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4401 Penn Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152241334",
            "country_code": "US",
            "telephone_number": "412-692-5325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCZKA",
        "first_name": "JENNA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080T0004X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Transplant Hepatology",
            "state": "PA",
            "license": "MA061182",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MA061182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jluczka@MMI-PA.direct.office.nextgen.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 Ridgeview Dr",
            "city": "Smithfield",
            "state": "PA",
            "country_code": "US",
            "postal_code": "154781650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Smithfield, PA

Sources for this page

Verify at the official NPI Registry.