MEDICARE: DR. STEFAN LUCAS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	229504	NY
2	207L00000X	Anesthesiology Physician	2025-03270	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G0189393590	OTHER	NY	BLUE CHOICE GROUP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	00026573501	OTHER	NY	UNIVERA PROV#
4	MDH685	OTHER	NY	PREFERRED CARE
5	7917460	OTHER	NY	AETNA PROV#
6	2222	OTHER	NY	BLUE SHIELD GROUP
7	P010229504	OTHER	NY	BLUE CHOICE

General Provider Information

NPI Number	:	1174541213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEFAN LUCAS M.D.

Provider Business Mailing Address
First Line	:	1300 CONCORD TER STE 420
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33323-2899
Country	:	US
Telephone Number	:	866-306-6007
Fax Number	:	704-248-5537

Provider Business Practice Location Address
First Line	:	1240 JEFFERSON RD
Second Line	:	SUITE C
City	:	ROCHESTER
State	:	NY
Zip	:	14623-3104
Country	:	US
Telephone Number	:	844-748-7242
Fax Number	:	844-586-2669

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	04/21/2026

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Directions to “ DR. STEFAN LUCAS M.D.” Practice Location

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