Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lucas R Derting, PA-C

Individual provider Physician Assistant · NPI 1306846381

Lucas R Derting, PA-C is a Physician Assistant in Pueblo, Colorado. Licensed in Colorado. Registered with an NPI since 2005.

Licensed in
CO
In the registry since
2005
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

1600 N Grand Ave Ste 500
Pueblo, CO 81003-2757
Phone: (719) 545-0663
Fax: (719) 595-7903
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1080 (CO)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 1080 (CO)

Record details

NPI number1306846381
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 29, 2005
Last updated in NPPESNovember 3, 2016

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