| Dr Gary J Luckasen, MD | |
|
2121 E Harmony Rd, Unit 100, Fort Collins, CO 80528-3401 | |
| (970) 221-1000 | |
| (970) 297-6860 |
| Full Name | Dr Gary J Luckasen |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine - Cardiovascular Disease |
| Location | 2121 E Harmony Rd, Fort Collins, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063418572 | NPI | - | NPPES |
| P00970356 | Other | NE | MEDICARE RAILROAD |
| 103400600 | Medicaid | WY | |
| 01207893 | Medicaid | CO | |
| P00910572 | Other | CO | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RC0000X | Internal Medicine - Cardiovascular Disease | 20789 (Colorado) | Primary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | 19652 (Nebraska) | Secondary |
| Entity Name | Poudre Valley Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225356868 PECOS PAC ID: 9638208549 Enrollment ID: O20100602000122 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Gary J Luckasen, MD 2121 E Harmony Rd, Suite 100, Fort Collins, CO 80528-3400 Ph: (970) 221-1000 | Dr Gary J Luckasen, MD 2121 E Harmony Rd, Unit 100, Fort Collins, CO 80528-3401 Ph: (970) 221-1000 |
Dr. Stephen A Treat, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 2121 E Harmony Rd, Ste 100, Fort Collins, CO 80528 Phone: 970-221-1000 Fax: 970-297-6844 | |
Dr. David Kindley Cobb, M.D. Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 2121 E Harmony Rd Unit 380, Fort Collins, CO 80528 Phone: 970-224-0429 | |
Dr. Diana M Breyer, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 2121 E Harmony Rd, Suite 300, Fort Collins, CO 80528 Phone: 970-224-9102 Fax: 970-224-9112 | |
Fred H Meyer, M.D. Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 219 S Sunset St, Fort Collins, CO 80521 Phone: 970-224-2156 Fax: 970-482-6936 | |
Robert A Simmons, MD Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 3702 S Timberline Rd, Fort Collins, CO 80525 Phone: 970-207-9773 Fax: 970-207-1893 | |
Amir Kalani, MD PHD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 2001 S Shields St Ste J3, Fort Collins, CO 80526 Phone: 970-315-1870 Fax: 970-315-1869 | |
Dr. Charles Timothy Johnson, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 2121 E Harmony Rd, Unit 100, Fort Collins, CO 80528 Phone: 970-221-1000 Fax: 970-297-6860 |