Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jeremy Tyler Luczak, PA-C

Individual provider Physician Assistant · NPI 1699516013

Jeremy Tyler Luczak, PA-C is a Physician Assistant in Mesa, Arizona. Qualified in 2025, 1 year ago. Practices with Pulmonary Associates PA, a 16-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
1
Licensed in
AZ
In the registry since
2024
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

5151 E Broadway Rd Ste 107
Mesa, AZ 85206-1346
Phone: (480) 290-7000
Fax: (602) 254-6840
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 11426 (AZ)

Record details

NPI number1699516013
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 3, 2024
Last updated in NPPESMarch 16, 2026
Certification dateMarch 16, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Pulmonary Associates Pa — 16 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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