Individual provider Active NPI

Marc Jay Lustig, MD

  • Ophthalmology Physician
  • New York, NY
National Provider Identifier
1053360149
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
222088 Issued in NY
Practice address
40 West 72ND St
New York, NY 10023
Phone
(212) 981-9800
Fax
(212) 981-9818
NPI assigned
May 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 222088 NY Primary

Addresses

Primary practice location

40 West 72ND St
New York, NY 10023

Mailing address

40 West 72ND St
New York, NY 10023
Phone (212) 981-9800

Other identifiers 1

IdentifierTypeStateIssuer
02577411MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040913000862 NY Practitioner - Ophthalmology 4486621174 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
New York University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Ophthalmic Care PCGroup PAC ID 4284987439, 11 clinicians

Practice addresses (Care Compare)

40 W 72ND St
New York, NY 10023-4119
Phone (212) 981-9800

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Ophthalmology CurrentSince Mar 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Ophthalmology CurrentSince Mar 1, 2021 Accepting new patients
Pediatric Ophthalmic Care PC CurrentSince Sep 10, 2018 Accepting new patients
Manhattan Eye Ear and Throat Hospital Past Accepting new patients

Locations

218 2nd Ave
New York, NY 10003
Phone (212) 979-4000

53 E 124th St
New York, NY 10035
Phone (212) 410-8000

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1053360149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 WEST 72ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10023",
            "telephone_number": "212-981-9800",
            "fax_number": "212-981-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 WEST 72ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10023",
            "telephone_number": "212-981-9800",
            "fax_number": "212-981-9818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTIG",
        "first_name": "MARC",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2026-07-13",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "222088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02577411",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.