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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MARY LUCKASEN
NPI 1366199754
Internal Medicine in Jbsa Ft Sam Houston, TX

Active since March 04, 2022PECOS Enrolled
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234(210) 916-5910(210) 916-2077 Get Directions Write a Review

NPPES record last updated: June 18, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 14, 2023, Aug 11, 2023, Mar 4, 2022 (3 updates tracked since 2022).

About Mary Luckasen NPPES

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

MARY LUCKASEN (NPI 1366199754) is an individual internal medicine provider in Jbsa Ft Sam Houston, Texas, licensed in Colorado (DR.0071968) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1366199754
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameMARY LUCKASEN
Location Address3551 ROGER BROOKE DRJbsa Ft Sam Houston, TX 78234-4504
Mailing Address3551 Roger Brooke DrJbsa Ft Sam Houston, TX 78234-4504 · (210) 916-5910 · Fax (210) 916-2077
Phone(210) 916-5910
Fax(210) 916-2077
Sole ProprietorYes
Enumeration DateMarch 4, 2022
Last NPPES UpdateJune 18, 20263 updates tracked since enumeration
NPPES CertifiedJune 18, 2026
✔ NPI 1366199754 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CO · DR.0071968
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
3551 ROGER BROOKE DR, Jbsa Ft Sam Houston, TX 78234
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Luckasen 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 78234 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

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.

JANET JONES SIMS CRNA
Nurse Anesthetist, Certified Registered
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (253) 223-6272
JAMES KENNEDY HARDIN PA-C
Physician Assistant
3551 ROGER BROOKE DR
JBSA FT SAM HOUSTON, TX 78234
Bexar County (210) 295-4996
DR. DANIEL VICTOR-CALVIN HAMMOND M.D.
Pediatrics (Pediatric Endocrinology)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (210) 916-3020
JESSICA FULLER LCSW
Social Worker (Clinical)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (210) 808-1859
DR. JASON ROBERT HALL M.D.
Neurological Surgery
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (210) 539-9582
MRS. KATHRYN ELAINE HELLAND LCSW
Social Worker (Clinical)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (210) 539-9582
DR. HALWARD BLEGEN IV DO
Ophthalmology
3551 ROGER BROOKE DR
JBSA FORT SAM HOUSTON, TX 78234
Bexar County (210) 220-7419
KOLE HOLLAND SPAULDING M.D.
Emergency Medicine (Emergency Medical Services)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (210) 539-9582

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Luckasen's NPI number?

The NPI number for Mary Luckasen is 1366199754. It was assigned to this individual provider in the NPPES registry on March 4, 2022.

Where is Mary Luckasen located?

Mary Luckasen practices at 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234. The listed phone number is (210) 916-5910.

What is Mary Luckasen's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Mary Luckasen enrolled in Medicare?

Yes. Mary Luckasen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mary Luckasen was last updated on June 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 53 days 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.