LUCAS W TIBBS (DO) – Internal Medicine Physician, NPI 1134863384

LUCAS W TIBBS (DO) is a healthcare provider. based in Poplar bluff, Missouri. specializing in INTERNAL MEDICINE. They hold the professional credentials DO. They hold a License No. 2025032987 (MO). The NPI Number for LUCAS W TIBBS (DO) is 1134863384

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
LUCAS W TIBBS (DO)
NPI
1134863384
Phone
(573) 714-4678
Address
41 KATHY CV
Enumeration Date
25 April 2022
Last Update Date
4 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2022 (4 years ago)
PAC ID
8820597537
Group Practice PAC ID
5991615072
Professional Enrollment ID
I20250819003548
Address ID
MO639013923PO225XXDRXX403
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:4State licenses:1Digital endpointsOther names

4,190 INTERNAL MEDICINE in MO

Provider Addresses for LUCAS W TIBBS (DO)

  • 41 KATHY CV

    POPLAR BLUFF, MO 639012095

    Phone: (573) 714-4678

    Type: Mailing

  • 3100 OAK GROVE RD

    POPLAR BLUFF, MO 639011573

    Phone: (573) 776-2000

    Type: Location

  • PO BOX 801143

    KANSAS CITY, MO 641801143

    Phone: (573) 331-5583

    Fax: (573) 331-5079

    Type: Mailing

  • 225 PHYSICIANS PARK STE 400

    POPLAR BLUFF, MO 639013923

    Phone: (573) 727-5500

    Fax: (573) 727-5599

    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 $22.

Total Amount is formed as General ($22) + Research ($0) + Ownership ($0) = $22.

Last reported payment date: 2024-09-19 • Largest payer in this snapshot: Alexion Pharmaceuticals, Inc. ($22).

Total Amount

$22

General + Research + Ownership

Payments

1

Total payment records

General Amount

$22

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-19

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2025-08-19

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
I20250819003548IInternal MedicineMOTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63901)

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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: 5991615072View full group profile
NameSpecialtyState
Nurse PractitionerMO
Clinical Social WorkerMO
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerMO
Clinical Social WorkerMO
Nurse PractitionerMO
Nurse PractitionerMO
Clinical Social WorkerMO
Nurse PractitionerMO

Reviews

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Frequently asked questions

What is the standard ID for LUCAS W TIBBS (DO) in the U.S.?
In the U.S., LUCAS W TIBBS (DO) is identified by NPI 1134863384.
Is LUCAS W TIBBS (DO)'s NPI status active today?
Active status means LUCAS W TIBBS (DO)'s NPI record is not deactivated in the public file.
What does the directory say LUCAS W TIBBS (DO) does?
Insurance directories may phrase it differently, but here LUCAS W TIBBS (DO) maps to Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to LUCAS W TIBBS (DO)?
LUCAS W TIBBS (DO) shows a connection to Poplar Bluff, Missouri in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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