Individual provider Active NPI

Luke Stanley Plucheck, MSN, APRN, CPNP-AC

  • Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1972203362
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1113743 Issued in TX
Practice address
4410 Medical Dr Ste 550
San Antonio, TX 78229-3755
Phone
(210) 575-7870
Fax
(210) 575-6131
NPI assigned
Mar 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Oncology Registered Nurse 163WP0218X 936274 TX
Acute Care Nurse Practitioner 363LA2100X 1113743 TX
Pediatric Nurse Practitioner 363LP0200X 1113743 TX
Nurse Practitioner 363L00000X 1113743 TX Primary

Addresses

Primary practice location

4410 Medical Dr Ste 550
San Antonio, TX 78229-3755

Mailing address

4410 Medical Dr Ste 550
San Antonio, TX 78229-3755
Phone (210) 575-7870

Other identifiers 1

IdentifierTypeStateIssuer
936274OtherTXRN LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230524002432 TX Practitioner - Nurse Practitioner 3870959463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Physician Practices PLLCGroup PAC ID 8022171974, 176 clinicians

Practice addresses (Care Compare)

4410 Medical Dr
Suite 550
San Antonio, TX 78229-3755
Phone (210) 575-2222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
936274TXMDPediatric Oncology Registered Nurse
1113743TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Physician Practices, PLLC CurrentSince Apr 24, 2023 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

111 Dallas St
Fl 4
San Antonio, TX 78205
Phone (210) 297-7195

4410 Medical Dr
Ste 550
San Antonio, TX 78229
Phone (210) 575-2222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16700/brand/2/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1972203362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 MEDICAL DR STE 550",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293755",
            "telephone_number": "210-575-7870",
            "fax_number": "210-575-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 MEDICAL DR STE 550",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293755",
            "telephone_number": "210-575-7870",
            "fax_number": "210-575-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUCHECK",
        "first_name": "LUKE",
        "middle_name": "STANLEY",
        "credential": "MSN, APRN, CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0218X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatric Oncology",
            "state": "TX",
            "license": "936274",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1113743",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1113743",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1113743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE NUMBER",
            "identifier": "936274",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.