Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lucas Martinus Suryakusuma, MPAS, PA-C

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1982252961

Lucas Martinus Suryakusuma, MPAS, PA-C is a Physician Assistant in Dallas, Texas. Qualified in 2019, 7 years ago. Practices with University of Texas Southwestern Medical Center at Dallas, a 3,149-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
7
Licensed in
TX
In the registry since
2019
Specialties on file
2
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

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Dallas, TX

No coordinates on file. Search this address in Google Maps

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA13328 (TX)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1982252961
Entity typeIndividual (Type 1)
GenderMale
Credentials MPAS , PA-C
Sole proprietorNo
NPI enumeratedSeptember 3, 2019
Last updated in NPPESApril 3, 2020
Certification dateApril 3, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice University Of Texas Southwestern Medical Center At Dallas — 3149 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Dallas