LUCAS PETTIT (NPI# 1245787159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245787159 |
| Entity Type | Individual |
| Full Name | LUCAS PETTIT |
| Practice Address |
8003 Brewerton Rd Cicero NY 13039-9528 |
| Mailing Address |
3292 Black St Scipio Center NY 13147-3172 |
| Practice Telephone | 3152884006 |
| Practice Fax Number | 3152884760 |
| Mailing Telephone | 3154066385 |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2019-12-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
8003 BREWERTON RD |
| City | CICERO |
| State | NY |
| Zip Code | 13039-9528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619980976 | Laurel Anne Delorme | Physician Assistant | 8003 Brewerton Rd, Cicero, NY 13039-9528 | 2006-08-15 |
| 1780294595 | Alexandra Louise Rubenstein | Nurse Practitioner | 8003 Brewerton Rd, Cicero, NY 13039-9528 | 2020-08-06 |
| 1164908745 | Wellnow Urgent Care, PC | Clinic/Center | 8003 Brewerton Rd, Cicero, NY 13039-9528 | 2018-07-17 |
| 1669725933 | Wellnow Urgent Care, PC | Clinic/Center | 8003 Brewerton Rd, Cicero, NY 13039-9528 | 2012-10-23 |
| 1497895387 | Gretchen L Brown | Emergency Medicine | 8003 Brewerton Rd, Cicero, NY 13039-9528 | 2007-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780238212 | Cody Hodgson | Physician Assistant | 6993 Van Antwerp Drive, East, Cicero, NY 13039 | 2019-08-01 |
| 1164989810 | Emily Grace Massey | Occupational Therapy Assistant | 5962 Rte 31, Cicero, NY 13039 | 2019-02-28 |
| 1356837512 | Jennifer Lonnen Dds Pllc | Dentist | 6221 Rt 31 Ste 102, Cicero, NY 13039 | 2018-07-10 |
| 1285186916 | Bismarck Np Psychiatric Services Pllc | Nurse Practitioner | 6221 Route 31, Suite 106, Cicero, NY 13039 | 2016-10-28 |
| 1386090397 | Kristin Raineri | Dentist | 5972 Rt 31, Cicero, NY 13039 | 2016-05-09 |
| 1053788281 | Empire Vision Center, Inc | Eyewear Supplier (Equipment, not the service) | 5653 East Circle Drive, Cicero, NY 13039 | 2015-08-24 |
| 1003251018 | Christina M Smith | Licensed Practical Nurse | 8449 Bayridge Rd, Cicero, NY 13039 | 2013-05-03 |
| 1134463433 | Margaret L Southard | Case Manager/Care Coordinator | 5962 Rt 31, Suite 7 Box 10, Cicero, NY 13039 | 2012-11-27 |
| 1245589852 | Samantha Danielle Dillon | Pharmacist | 8061 Brewerton Road, Cicero, NY 13039 | 2012-08-29 |
| 1861769168 | Laura Shaw | Counselor | 6221 Rt. 31, Suite 110, Cicero, NY 13039 | 2011-11-30 |
| Find all providers in zip 13039 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225140536 | David R Downey Jr. | Physician Assistant | 6251 State Route 31, Cicero, NY 13039-8714 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487252581 | North Shore Medical Group Pllc | Physician Assistant | 311 Skyview Ter, Syracuse, NY 13219-2835 | 2020-10-12 |
| 1477169654 | Kristen Ariel O'connell | Physician Assistant | 85 John St Apt 7a, New York, NY 10038-2844 | 2020-09-22 |
| 1699381616 | David Nmn Kao | Physician Assistant | 737 Pleasant Avenue, Westbury, NY 11590-6407 | 2020-09-16 |
| 1043824816 | Elizabeth Keane | Physician Assistant | 25 Hollis Dr, Sound Beach, NY 11789-1629 | 2020-08-31 |
| 1497364111 | Tianna Stephens | Physician Assistant | 165 N Village Ave Ste 5, Rockville Centre, NY 11570-3701 | 2020-07-28 |
| 1124636188 | Shannon Maureen O'connell | Physician Assistant | 270-05 270th Ave, New Hyde Park, NY 11040 | 2020-07-16 |
| 1841818895 | Yanick Dugue | Physician Assistant | 4 Lincoln Ave, New Hyde Park, NY 11040-3125 | 2020-07-07 |
| 1194340505 | Kayleigh Marie Tourt | Physician Assistant | 222 Alexander St Fl 4, Rochester, NY 14607-4039 | 2020-06-11 |
| 1023638509 | Kristina Rajic | Physician Assistant | 7237 66th Dr, Flushing, NY 11379-2111 | 2020-04-24 |
| 1114547791 | Michele Hein | Physician Assistant | 700 Veterans Memorial Hwy, Hauppauge, NY 11788-2952 | 2020-04-23 |
| Find all providers with the same taxonomy | ||||
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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.