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MS. LUCETTA LYNNE LYFORD PA-C
NPI 1396749800
Physician Assistant in Portage, MI

Active since June 13, 2005Opted out of Medicare · through Jul 1, 2028
430 W. CENTRE AVE., PORTAGE, MI 49024(269) 321-6673 Get Directions Write a Review

NPPES record last updated: August 7, 2007. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Ms. Lucetta Lynne Lyford Pa-c NPPES

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

MS. LUCETTA LYNNE LYFORD PA-C (NPI 1396749800) is an individual physician assistant in Portage, Michigan, licensed in Michigan (5601003467) and active in the NPI registry since June 2005. She has opted out of Medicare through July 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1396749800
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMS. LUCETTA LYNNE LYFORDCredential: PA-C
Location Address430 W. CENTRE AVE.Portage, MI 49024
Mailing Address430 W. Centre Ave.Portage, MI 49024 · (269) 321-6673
Phone(269) 321-6673
Sole ProprietorNo
Enumeration DateJune 13, 2005
Last NPPES UpdateAugust 7, 2007
✔ NPI 1396749800 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MI · 5601003467
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
430 W. CENTRE AVE., Portage, MI 49024
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Other Identifiers 2

Medicare UPINQ39077MI
Medicare ID-Type UnspecifiedON50600MI

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ms. Lucetta Lynne Lyford Pa-c has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2010 through July 1, 2028.

Opt-Out Effective DateJuly 1, 2010
Opt-Out In Effect ThroughJuly 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49024 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Lucetta Lyford's NPI number?

The NPI number for Lucetta Lyford is 1396749800. It was assigned to this individual provider in the NPPES registry on June 13, 2005.

Where is Lucetta Lyford located?

Lucetta Lyford practices at 430 W. Centre Ave., Portage, MI 49024. The listed phone number is (269) 321-6673.

What is Lucetta Lyford's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Lucetta Lyford enrolled in Medicare?

No. Lucetta Lyford has opted out of Medicare through July 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Lucetta Lyford was last updated on August 7, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.