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JEREMY TYLER LUCZAK PA-C
NPI 1699516013
Physician Assistant in Mesa, AZ

Active since June 03, 2024PECOS EnrolledAccepts Medicare Assignment
5151 E BROADWAY RD STE 107, MESA, AZ 85206(480) 290-7000(602) 254-6840 Get Directions Write a Review

NPPES record last updated: March 16, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 16, 2026, Nov 6, 2025, Jun 3, 2024 (3 updates tracked since 2024).

About Jeremy Tyler Luczak Pa-c NPPES

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

JEREMY TYLER LUCZAK PA-C (NPI 1699516013) is an individual physician assistant in Mesa, Arizona, licensed in Arizona (11426) and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1699516013
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJEREMY TYLER LUCZAKCredential: PA-C
Location Address5151 E BROADWAY RD STE 107Mesa, AZ 85206-1346
Mailing Address5151 E Broadway Rd Ste 107Mesa, AZ 85206-1346 · (480) 290-7000 · Fax (602) 254-6840
Phone(480) 290-7000
Fax(602) 254-6840
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateJune 3, 2024
Last NPPES UpdateMarch 16, 20263 updates tracked since enumeration
NPPES CertifiedMarch 16, 2026
✔ NPI 1699516013 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 AZ · 11426
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.
5151 E BROADWAY RD STE 107, Mesa, AZ 85206
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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 and accepts Medicare assignment

Jeremy Tyler Luczak Pa-c 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 ID4981196631
PECOS Enrollment IDI20251120003548
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 85206 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
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 6

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

AMBER LEN HAUSKINS PA-C
Physician Assistant
5151 E BROADWAY RD STE 107
MESA, AZ 85206
Maricopa County (480) 290-7000
JUDITH ANNE NEWELL FNP-BC
Nurse Practitioner (Family)
5151 E BROADWAY RD STE 107
MESA, AZ 85206
Maricopa County (480) 290-7000
TERESA CAROL HEATLY MD
Internal Medicine (Pulmonary Disease)
5151 E BROADWAY RD STE 107
MESA, AZ 85206
Maricopa County (480) 290-7000
PULMONARY ASSOCIATES, PA
Internal Medicine (Pulmonary Disease)
5151 E BROADWAY RD STE 107
MESA, AZ 85206
Maricopa County (480) 290-7000
THOMAS KUNELIS DO
Internal Medicine (Pulmonary Disease)
5151 E BROADWAY RD STE 107
MESA, AZ 85206
Maricopa County (480) 290-7000
MARIA MAGDALENA RAMIREZ STOCKMAN MD
Internal Medicine (Pulmonary Disease)
5151 E BROADWAY RD STE 107
MESA, AZ 85206
Maricopa County (480) 290-7000

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 Jeremy Luczak's NPI number?

The NPI number for Jeremy Luczak is 1699516013. It was assigned to this individual provider in the NPPES registry on June 3, 2024.

Where is Jeremy Luczak located?

Jeremy Luczak practices at 5151 E Broadway Rd Ste 107, Mesa, AZ 85206. The listed phone number is (480) 290-7000.

What is Jeremy Luczak's specialty?

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

Is Jeremy Luczak enrolled in Medicare?

Yes. Jeremy Luczak is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jeremy Luczak was last updated on March 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.