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

Timothy Robert Lucisano, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1699702043

Timothy Robert Lucisano, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Charlotte, North Carolina. Qualified in 2003, 23 years ago. Practices with Chs Anesthesia Services Group Inc, a 737-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
23
Licensed in
NC
In the registry since
2006
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

10628 Park Rd Anesthesia Dept
Charlotte, NC 28210-8407
Phone: (704) 667-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 102492 (NC)

Record details

NPI number1699702043
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedJune 28, 2006
Last updated in NPPESAugust 14, 2008

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Chs Anesthesia Services Group Inc — 737 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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