Individual provider Active NPI

Ramon Lustestica Ignacio, MD

  • Hospitalist Physician
  • Iowa City, IA
National Provider Identifier
1043405814
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD-47402 Issued in IA
Practice address
500 E Market St
Iowa City, IA 52245-2633
Phone
(319) 339-3551
NPI assigned
Sep 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 064649 GA
Hospitalist Physician 208M00000X MD-47402 IA Primary
Internal Medicine Physician 207R00000X MD-47402 IA
Internal Medicine Physician 207R00000X 064649 GA
Internal Medicine Physician 207R00000X P3732 TX
Internal Medicine Physician 207R00000X 10511724-1205 UT

Addresses

Primary practice location

500 E Market St
Iowa City, IA 52245-2633

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 339-3551

Other identifiers 6

IdentifierTypeStateIssuer
P00870118OtherRAILROAD MEDICARE
01393936OtherAMERIGROUP
GA1116MedicaidSC
486524862AMedicaidGA
52289319-001OtherGABCBS
564147OtherGAWELLCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200526001955 IA Practitioner - HospitalistPractitioner - Internal Medicine 5193918605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State University of IowaGroup PAC ID 7618884230, 1,886 clinicians

Practice addresses (Care Compare)

500 E Market St
University of Iowa Health Care Medical Cent
Iowa City, IA 52245-2633
Phone (319) 339-0300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.02 of 100Reported as group
Quality
75.68
Promoting interoperability
78
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P3732TXMDInternal Medicine Physician
10511724-1205UTMDInternal Medicine Physician
064649GAMDHospitalist Physician
MD-47402IAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State University of Iowa Family Medicine CurrentSince Jan 31, 2024 Accepting new patients
State University of Iowa Past Accepting new patients
Memorial Health University Medical Center, Inc. Family Medicine Past Accepting new patients

Locations

500 E Market St
Iowa City, IA 52245
Phone (319) 339-0300

200 Hawkins Dr
#H
Iowa City, IA 52242
Phone (319) 356-1616

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616

540 E Jefferson St
Ste 400
Iowa City, IA 52245
Phone (319) 339-3400

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1043405814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-339-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E MARKET ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452633",
            "telephone_number": "319-339-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGNACIO",
        "first_name": "RAMON",
        "middle_name": "LUSTESTICA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-13",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "064649",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IA",
            "license": "MD-47402",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "MD-47402",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "064649",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P3732",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "10511724-1205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00870118",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01393936",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GA1116",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "486524862A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52289319-001",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "564147",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.