Individual provider · Type 1 NPI

Jeremy Tyler Luczak, PA-C

Physician Assistant · Mesa, AZ

NPI number 1699516013 Active

Practice location

5151 E Broadway Rd Ste 107
Mesa, AZ 85206-1346

Call (480) 290-7000 Map

Fax (602) 254-6840

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X11426 (AZ)

Physician Assistant: 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, orde…

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About NPI 1699516013

Jeremy Tyler Luczak, PA-C's National Provider Identifier is 1699516013, issued on Jun 3, 2024. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Mesa, AZ. The record was last updated on Mar 16, 2026.