DR. MARK A LUCAS (NPI# 1407890882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407890882 |
| Entity Type | Individual |
| Full Name | DR. MARK A LUCAS |
| Credential | M.D. |
| Practice Address |
601 John St Suite M-206c Kalamazoo MI 49007-5341 |
| Practice Telephone | 2693499745 |
| Practice Fax Number | 2693491013 |
| Mailing Telephone | 2693499745 |
| Mailing Fax Number | 2693491013 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2020-10-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 4301037689 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS IND PIN | 3403957061 | 01 |
| MI | BCBS GRP PIN | 340C910480 | 01 |
| AETNA PIN | 4361735 | 01 | |
| MI | 2999271-10 | 05 | |
| GREAT LAKES HLTH PLN | 111760 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821334343 | Mark Austin Lucas | Physical Therapist | 1325 Somersby Ln, Matthews, NC 28105-1575 | 2013-01-02 |
| 1578648135 | Mark Anthony Lucas | Chiropractor | 1261 Lincoln Ave, 112, San Jose, CA 95125-3006 | 2006-10-25 |
| 1932289865 | Mark C Lucas | Dentist | 10461 Park Meadows Dr, #101, Lone Tree, CO 80124-5306 | 2006-10-16 |
| 1326096207 | Mark S. Lucas | Podiatrist | 2395 Tech Dr, Ste 4, Bettendorf, IA 52722 | 2006-05-04 |
| 1164545497 | Mark T Lucas | Physical Therapist | 5525 Broadway, Merrillville, IN 46410 | 2007-04-10 |
| 1912019522 | Mark William Lucas | Dentist | 4170 Lennon Rd, Suite C, Flint, MI 48507-1083 | 2006-08-31 |
| Street Address |
601 JOHN ST SUITE M-206C |
| City | KALAMAZOO |
| State | MI |
| Zip Code | 49007-5341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134122757 | Joan K. Slager | Advanced Practice Midwife | 601 John St, Ste N-1200, Kalamazoo, MI 49007-5341 | 2005-05-27 |
| 1841898780 | Alexandra Marie Christmas | Physician Assistant | 601 John St, Kalamazoo, MI 49007-5341 | 2020-10-13 |
| 1003423237 | Ochuko Andrew Oghor | Student in an Organized Health Care Education/Training Program | 601 John St, Kalamazoo, MI 49007-5341 | 2020-10-01 |
| 1710591680 | Marshe Suderman | Nurse Practitioner | 601 John St, Kalamazoo, MI 49007-5341 | 2020-09-08 |
| 1609485481 | Kristy Lynn Mumby | Nurse Practitioner | 601 John St, Kalamazoo, MI 49007-5341 | 2020-07-28 |
| 1407475700 | Bethany Hodges | Dietitian, Registered | 601 John St, Kalamazoo, MI 49007-5341 | 2020-04-16 |
| 1760031157 | Michael Nestorak | Emergency Medicine | 601 John St, Kalamazoo, MI 49007-5341 | 2019-09-09 |
| 1639728272 | James Michael Curtis | Pharmacist | 601 John St, Kalamazoo, MI 49007-5341 | 2019-09-06 |
| 1538716451 | Sheri Jones | Physical Therapist | 601 John St, Kalamazoo, MI 49007-5341 | 2019-08-26 |
| 1790332658 | Jill Marie Woodhams | Occupational Therapist | 601 John St, Kalamazoo, MI 49007-5341 | 2019-08-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881248342 | Whitney Kiel | Pharmacist | 601 John Street Suite M-020, Kalamazoo, MI 49007 | 2019-08-01 |
| 1316591571 | Laura Jedele | Physical Therapist | Bronson Healthcare Group, 601 John St, Kalamazoo, MI 49007 | 2019-07-26 |
| 1992209084 | Yvonne Marie Heltzel | Behavior Technician | 1826 N Rose St, Kalamazoo, MI 49007 | 2018-03-22 |
| 1396263943 | Travis Todd Turrell | Physician Assistant | 125 S Kalamazoo Mall Suite 204, Kalamazoo, MI 49007 | 2017-09-05 |
| 1619493186 | Sarah Zuspann | Nurse Practitioner | 601 John Street, Suite 100, Kalamazoo, MI 49007 | 2017-08-16 |
| 1720529779 | Dannison | Psychologist | 604 S Rose St, Kalamazoo, MI 49007 | 2017-03-10 |
| 1265988901 | Calee Dieleman | Social Worker | 610 South Burdick, Kalamazoo, MI 49007 | 2016-09-01 |
| 1508313099 | Arriel Julia Ampey | Social Worker | 414 S. Burdick St., Suite 200, Kalamazoo, MI 49007 | 2016-09-01 |
| 1043662745 | Holloway Marston | Psychologist | 717 W South St, Apt. #6, Kalamazoo, MI 49007 | 2016-07-06 |
| 1205280062 | Bronson At Home | Home Health | 601 John St Ste M-431, Kalamazoo, MI 49007 | 2016-04-19 |
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| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316246192 | Julie Anne Brownell | Urology | 601 John Street, Sutie M318, Kalamazoo, MI 49007-5341 | 2011-03-20 |
| 1972815348 | Frederick Ian Berg | Urology | 601 John St, Kalamazoo, MI 49007-5341 | 2010-07-13 |
| 1912149683 | Pamela Sue Baron | Urology | 601 John St, Ste M206c, Kalamazoo, MI 49007-5341 | 2009-03-27 |
| 1215158191 | Healthcare Midwest PC | Urology | 601 John St, Suite M206c, Kalamazoo, MI 49007-5341 | 2007-05-01 |
| 1164466009 | Paul L Vandenbrink | Urology | 601 John St, Suite M-206c, Kalamazoo, MI 49007-5341 | 2006-06-15 |
| 1972546059 | Robert R Isacksen | Urology | 601 John St, Suite M206c, Kalamazoo, MI 49007-5341 | 2006-06-14 |
| 1548203540 | Anthony Raymond Gauthier Jr. | Urology | 1535 Gull Rd, Suite 150, Kalamazoo, MI 49048-1650 | 2006-06-14 |
| 1134161268 | James B Bour | Urology | 601 John St, Suite M206c, Kalamazoo, MI 49007-5341 | 2006-06-12 |
| 1285672493 | Gregor W Blix | Urology | 601 John St, Suite M206, Kalamazoo, MI 49007-5341 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477488 | Munson Healthcare Charlevoix Hospital | Urology | 11695 Park Ave, Suite A, Charlevoix, MI 49720 | 2020-11-06 |
| 1396235610 | Munson Medical Center | Urology | 405 N Division Rd Ste 2, Petoskey, MI 49770-9046 | 2018-05-11 |
| 1770072498 | Bellin Health Iron Mountain Inc | Urology | 1005 S Hemlock St Ste B, Iron Mountain, MI 49801-3854 | 2018-05-08 |
| 1205215621 | Alexander David Tapper | Urology | 44200 Woodward Ave Ste 207, Pontiac, MI 48341-5045 | 2015-05-19 |
| 1912324211 | Boston Medical Group, P.C. | Urology | 24901 Northwestern Hwy., Suite 615, Southfield, MI 48075 | 2014-03-25 |
| 1548600984 | Katie Marie Rosen | Urology | 19991 Hall Rd Ste 201, Macomb, MI 48044 | 2013-06-30 |
| 1609213636 | Arya Khatiwoda | Urology | 2900 Hannah Blvd Ste 104, East Lansing, MI 48823-5380 | 2013-05-31 |
| 1003179730 | Kalen Jacob Rimar | Urology | 130 Town Center Dr Ste 101, Troy, MI 48084 | 2012-06-18 |
| 1780955294 | Harry Nicholas Kotsis | Urology | 265 Touraine Rd, Grosse Pointe Farms, MI 48236-3308 | 2012-01-16 |
| 1750678264 | Michael Kozminski | Urology | 245 Cherry St Se Ste 202, Grand Rapids, MI 49503-4607 | 2011-07-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.