DR. REVANA LUKMAN (M.D.) – Obstetrics & Gynecology Physician, NPI 1104176668

DR. REVANA LUKMAN (M.D.) is a healthcare provider. based in Los angeles, California. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials M.D.. They hold a License No. A129808 (CA). The NPI Number for DR. REVANA LUKMAN (M.D.) is 1104176668

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
DR. REVANA LUKMAN (M.D.)
NPI
1104176668
Phone
(310) 301-8707
Address
5767 W CENTURY BLVD STE 400
Enumeration Date
12 September 2012
Last Update Date
7 August 2019

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
Secondary Phone
3103164373
Graduation Year
2012 (14 years ago)
PAC ID
8729395751
Group Practice PAC ID
4587857727
Professional Enrollment ID
I20180821003140
Address ID
CA905034522TO4201XBLVD301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

4,008 OBSTETRICS/GYNECOLOGY in CA

Provider Addresses for DR. REVANA LUKMAN (M.D.)

  • 5767 W CENTURY BLVD STE 400

    LOS ANGELES, CA 900455631

    Phone: (310) 301-8707

    Type: Mailing

  • 4201 TORRANCE BLVD STE 600

    TORRANCE, CA 905034523

    Phone: (310) 316-4373

    Fax: (310) 316-1291

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $18.

Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.

Last reported payment date: 2024-05-15 • Largest payer in this snapshot: Organon LLC ($18).

Total Amount

$18

General + Research + Ownership

Payments

1

Total payment records

General Amount

$18

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-15

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Organon LLC$18
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-08-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180821003140IObstetrics/GynecologyCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G0101Cervical or vaginal cancer screening; pelvic and clinical breast examination2222$0
Q0091Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory1515$0
99203New patient office or other outpatient visit, 30-44 minutes1414$0
99213Established patient office or other outpatient visit, 20-29 minutes1211$0
View full utilization report →

Insurance plans in this area (ZIP 90045)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4587857727View full group profile

Reviews

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Frequently asked questions

Does DR. REVANA LUKMAN (M.D.) have a public NPI I can cite?
Public records show DR. REVANA LUKMAN (M.D.) under NPI 1104176668.
Quick check: is DR. REVANA LUKMAN (M.D.) active?
Public NPPES data shows DR. REVANA LUKMAN (M.D.) with an active NPI status right now.
What type of care does DR. REVANA LUKMAN (M.D.) provide?
DR. REVANA LUKMAN (M.D.)'s profile centers on Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. REVANA LUKMAN (M.D.)?
DR. REVANA LUKMAN (M.D.) is associated with Los Angeles, California in the same public data insurers reference.
Why is information missing for DR. REVANA LUKMAN (M.D.)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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