Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JEREMY TYLER LUCZAK, PA-C
Active Sole ProprietorJEREMY TYLER LUCZAK, PA-C is a Physician Assistant healthcare provider located in MESA, Arizona. NPI 1699516013 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · MESA, AZ
Registration Details
- NPI Number
- 1699516013
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 3, 2024 (2.402347883578 yrs)
- Last Updated
- Nov 6, 2025
- License
-
11426 (AZ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
5151 E BROADWAY RD STE 107MESA, AZ, 852061346Browse AZ providers · Browse ZIP 85206
- Phone
- 4802907000
- Fax
- 4803253461
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in MESA, AZ
| Name | Credential | NPI |
|---|---|---|
| MR. JOHN ANDREW NELSON | P.A.-C | 1992799662 |
| CHRISTINE ANN CARY | PA | 1538155874 |
| MELISSA CAROL GALLETTA | PAC | 1508841248 |
| LAURIE GIACOLETTO | PA-C | 1477539138 |
| RENEE M LITTLE | PA | 1205806122 |
| MICHAEL DARREN JACKSON | P.A. | 1154394039 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.