DR. GARY J LUCKASEN M.D. NPI 1063418572

NPI Information

NPI: 1063418572
Provider Name: DR. GARY J LUCKASEN, M.D.
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

PECOS Registration: Yes

Address:
2121 E HARMONY RD
UNIT 100
FORT COLLINS, CO
ZIP 80528
Phone: (970) 221-1000
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DR. Gary J Luckasen, M.D. is a cardiovascular disease internal medicine in Fort Collins, CO. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. DR. Gary J Luckasen, M.D. NPI is 1063418572. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2121 E HARMONY RD
UNIT 100
FORT COLLINS, CO
ZIP 80528-401
Phone: (970) 221-1000
Fax: (970) 297-6860

The NPI 1063418572 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/21/2005 and was last updated on 6/12/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	19652	NEBRASKA	No
2	207RC0000X	Internal Medicine	Cardiovascular Disease	20789	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	D23832	MEDICARE UPIN
2	P00970356	OTHER	NEBRASKA	MEDICARE RAILROAD
3	P00910572	OTHER	COLORADO	MEDICARE RAILROAD
4	COA102396	MEDICARE PIN	COLORADO
5	NA1625013	MEDICARE PIN	NEBRASKA
6	NA1626013	MEDICARE PIN	NEBRASKA
7	103400600	MEDICAID	WYOMING
8	01207893	MEDICAID	COLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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