LUCKY AMEDU NP
NPI 1356882138
Nurse Practitioner - Gerontology in Minneapolis, MN

Q: What is Lucky Amedu's NPI number?

The NPI number for Lucky Amedu is 1356882138. It was assigned to this individual provider in the NPPES registry on March 14, 2017.

Q: What is Lucky Amedu's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Lucky Amedu was last updated on March 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 14, 2017PECOS Enrolled

2925 CHICAGO AVE, MINNEAPOLIS, MN 55407(612) 262-7800 Get Directions Write a Review

NPPES record last updated: March 1, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 1, 2022, Nov 11, 2019, Apr 23, 2018 and 1 more (4 updates tracked since 2017).

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About Lucky Amedu Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LUCKY AMEDU NP (NPI 1356882138) is an individual gerontology provider in Minneapolis, Minnesota, licensed in Minnesota (5058) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS and maintains a secondary practice location in Minneapolis.

NPPES Registry Identity

NPI1356882138

Entity TypeIndividualMale

Primary Taxonomy363LG0600X

Provider Legal NameLUCKY AMEDUCredential: NP

Location Address2925 CHICAGO AVEMinneapolis, MN 55407-1321

Mailing Address2925 Chicago AveMinneapolis, MN 55407-1321 · (126) 262-9000

Phone(612) 262-7800

Sole ProprietorNo

Enumeration DateMarch 14, 2017

Last NPPES UpdateMarch 1, 20224 updates tracked since enumeration

NPPES CertifiedMarch 1, 2022

✔ NPI 1356882138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in MN · 5058

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License CNP 5058 (MN)

2925 CHICAGO AVE, Minneapolis, MN 55407

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Secondary Practice Location 1

Location 11415 Lilac Dr N Ste 190Minneapolis, MN 55422-4544 · Phone (763) 267-8701 · Fax (763) 231-9602

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lucky Amedu Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55407 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TRACI ARNETTE ROBERTS M.D.

Internal Medicine