Deactivated NPI 1306846381 Deactivated / Inactive NPI Male Practitioner

Lucas R Derting , PA-C

Physician Assistant • Pueblo, CO

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Lucas Derting has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 29, 2005

NPI Deactivation Date March 22, 2006

Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Lucas Derting, PA-C was a registered Physician Assistant practicing in Pueblo, CO. Throughout an active medical career spanning 1 years, Lucas Derting provided care at the practice location at 1600 NORTH GRAND AVENUE until profile deactivation on 2006-03-22.

Historical Medicare Part B clinical services included established patient outpatient office visit, injection, triamcinolone acetonide, not otherwise specified, 10 mg, injection, ketorolac tromethamine, per 15 mg. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

1600 North Grand Avenue
Suite 500

Pueblo, CO 810032757

Telephone 7195450663

Fax 7195957903

Associated Practice Facility / Clinic

🏢 Cardiovascular And Thoracic Surgical Associates Facility NPI 1053464669

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Pueblo, CO

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 12.3 Yrs

State Avg: 13.1 Yrs

Regional Practice Density

61 Specialists

Practicing in Pueblo, CO (3810 Statewide)

Telehealth Adoption Rate

8.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

54.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	140	120	$224.02	$108.65
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	128	18	$3.00	$0.95
J1885 Injection, ketorolac tromethamine, per 15 mg	28	11	$3.00	$0.55
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	14	14	$350.48	$154.68
72050 X-ray of upper spine, 4 or 5 views	13	13	$82.00	$42.54
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	13	13	$426.97	$188.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	102	15	$3.00	$1.11
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	70	57	$205.00	$109.81
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$265.00	$143.79
99213 Established patient office or other outpatient visit, typically 15 minutes	11	11	$135.00	$78.33

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	11	11	$141.00	$79.09

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	22	21	$282.00	$169.24
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	13	11	$192.54	$116.45

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	13	13	$311.00	$170.87

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	20	20	$311.00	$166.59
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	14	14	$211.00	$105.81
33533 Coronary artery bypass using artery graft, 1 graft	11	11	$590.80	$255.30

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	25	25	$312.00	$174.06
33533 Coronary artery bypass using artery graft, 1 graft	15	15	$745.51	$236.76
33508 Harvest of veins for coronary artery bypass procedure using an endoscope	12	12	$6.93	$2.28
32663 Examination of lung with removal of lung lobe using an endoscope	12	12	$440.20	$196.69

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
33508 Harvest of veins for coronary artery bypass procedure using an endoscope	22	22	$5.32	$2.28
33533 Coronary artery bypass using artery graft, 1 graft	22	22	$591.40	$257.75
33518 Coronary artery bypass using vein or artery graft, 2 grafts	16	16	$130.60	$58.21
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	14	14	$210.00	$106.70
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	13	13	$311.00	$167.70

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License CO 1080

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.

Physician Assistant - Surgical

NUCC Taxonomy Code: 363AS0400X

State License CO 1080

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

63720345 (CO)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners

Dr. Greg Bowman , MD

Internal Medicine - Cardiovascular Disease

NPI 1023079035

Doctor of Medicine (M.D.)

Dr. Carl Adams , MD

Thoracic Surgery (Cardiothoracic Vascular Surgery)

NPI 1669433751

Doctor of Medicine (M.D.)

Terry Embaugh , PA-C

Physician Assistant

NPI 1952510919

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

📍

Updated Practice Location November 03, 2016

Registered at 1600 NORTH GRAND AVENUE, SUITE 500, PUEBLO, CO 810032757 (Tel: 7195450663)

📍

Updated Business Mailing Address November 03, 2016

Registered at PO BOX 560825, DENVER, CO 802560825 (Tel: 7195957580)

👤

Provider Name / Credentials Updated November 03, 2016

Recorded as LUCAS DERTING, PA-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 03, 2016

Physician Assistant (License #1080 in CO)

🔄

NPI Profile Reactivated April 11, 2006

Record officially reactivated for active practice on April 11, 2006

⚠️

NPI Profile Deactivated March 22, 2006

Record deactivated on March 22, 2006

🟢

Initial NPI Registration & Enumeration July 29, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

No patient reviews submitted yet for Lucas Derting. Be the first to share your experience!

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1306846381

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 29, 2005

Last Update: November 03, 2016

Deactivation Date: March 22, 2006

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 560825

Denver, CO 802560825

Phone: 7195957580

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.