MR. LUCAS ALAN GRAVELYN CRNA
NPI 1528337375
Nurse Anesthetist, Certified Registered in Fort Wayne, IN

Q: What is Lucas Gravelyn's NPI number?

The NPI number for Lucas Gravelyn is 1528337375. It was assigned to this individual provider in the NPPES registry on December 23, 2011.

Q: What is Lucas Gravelyn's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Q: When was this NPI record last updated?

The NPPES record for Lucas Gravelyn was last updated on November 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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 December 23, 2011Accepts Medicare Assignment

6435 W JEFFERSON BLVD # 434, FORT WAYNE, IN 46804(260) 436-7875(260) 432-9812 Get Directions Write a Review

NPPES record last updated: November 3, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 3, 2025, Jun 7, 2017, Apr 27, 2017 (3 updates tracked since 2017).

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About Mr. Lucas Alan Gravelyn Crna NPPES

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

MR. LUCAS ALAN GRAVELYN CRNA (NPI 1528337375) is an individual nurse anesthetist, certified registered in Fort Wayne, Indiana, licensed in Indiana (28270719A) and active in the NPI registry since December 2011. He is affiliated with Lutheran Hospital Of Indiana, maintains a secondary practice location in Kalamazoo, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1528337375

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameMR. LUCAS ALAN GRAVELYNCredential: CRNA

Location Address6435 W JEFFERSON BLVD # 434Fort Wayne, IN 46804-6203

Mailing AddressPo Box 843603Dallas, TX 75284-0001 · (972) 233-1999 · Fax (972) 233-3666

Phone(260) 436-7875

Fax(260) 432-9812

Sole ProprietorNo

Medical School CMSOtherGraduated 2011

Enumeration DateDecember 23, 2011

Last NPPES UpdateNovember 3, 20253 updates tracked since enumeration

NPPES CertifiedNovember 3, 2025

✔ NPI 1528337375 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

Licenses✔ Licensed in IN · 28270719A✔ Licensed in MI · 4704255424

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

6435 W JEFFERSON BLVD # 434, Fort Wayne, IN 46804

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Secondary Practice Location 1

Location 1900 Peeler StKalamazoo, MI 49008-2300 · Phone (269) 345-8618 · Fax (269) 345-1508

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Lucas Alan Gravelyn Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7517124092

PECOS Enrollment IDI20120210000805, I20251008001182, I20251129000402

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lutheran Hospital Of Indiana

Acute Care Hospitals · Fort Wayne, IN

3/5 CMS rating

OwnershipProprietary

CMS Certification Number150017

Location7950 W Jefferson BlvdFort Wayne, IN 46804 · Allen County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46804 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

$122.49 typical visit price

range $53.07 – $161.76

Typical copayment $30.62 (range $13.26 – $40.44)

Most-billed visit code 99204

Established Patient

$66.48 typical visit price

range $16.93 – $132.22

Typical copayment $16.62 (range $4.23 – $33.05)

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.

Other Providers at the Same Location NPPES 16

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

KENNETH ALAN BURCKARDT M.D.

Anesthesiology