Individual provider Active NPI

David M Lucero, MD

  • Family Medicine Physician
  • Oceanside, CA
National Provider Identifier
1972511186
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G74961 Issued in CA
Practice address
1219 Larchwood Dr
Oceanside, CA 92056-6407
Phone
(760) 855-8882
NPI assigned
Aug 3, 2006
Last updated
Nov 21, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G74961 CA
Family Medicine Physician 207Q00000X G74961 CA Primary

Addresses

Primary practice location

1219 Larchwood Dr
Oceanside, CA 92056-6407

Mailing address

PO Box 4585
Oceanside, CA 92052-4585
Phone (760) 855-8882

Other identifiers 2

IdentifierTypeStateIssuer
9943731MedicaidCA
G74961OtherCAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040122000799 CA Practitioner - Emergency Medicine 6608778402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, Davis School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Joaquin Emergency Medical AssociatesGroup PAC ID 6305022047, 14 clinicians

Practice addresses (Care Compare)

333 Mercy Ave
Merced, CA 95340-8319
Phone (209) 564-5140

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74961CAMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
San Joaquin Emergency Medical Associates Emergency Medicine CurrentSince Jan 10, 2019 Accepting new patients
Chase Dennis Emergency Medical Group Inc Emergency Medicine Past Accepting new patients
Premier Emergency Physicians of California Medical Group PC Emergency Medicine Past Accepting new patients
Valley Emergency Physicians Medical Group, Inc Emergency Medicine Past Accepting new patients
David M Lucero MD Inc. Past Accepting new patients
Regional Radiological Associates, Inc. a Medical Group Past Accepting new patients

Locations

333 Mercy Ave
Merced, CA 95340
Phone (209) 385-1280

Organizations & group practices 7

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 1

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1972511186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4585",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920524585",
            "telephone_number": "760-855-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 LARCHWOOD DR",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920566407",
            "telephone_number": "760-855-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCERO",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G74961",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G74961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9943731",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "G74961",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.