Active NPI
Eric Steven Lustig, D.P.M.
- Podiatrist
- Philadelphia, PA
National Provider Identifier
1063419117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- SC002614L
- Practice address
- 4715 Pine St
Philadelphia, PA 19143-1831 - Phone
- (215) 471-0433
- Fax
- (215) 471-0430
- NPI assigned
- Jul 5, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | SC002614L | PA | Primary |
Addresses
Primary practice location
4715 Pine St
Philadelphia, PA 19143-1831
Mailing address
6836 Roosevelt Blvd
Philadelphia, PA 19149-2411
Phone (214) 471-0433
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LU1436109 | Other | PA | PA. BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100420000566 | PA | Practitioner - Podiatry | 2668509852 | Practice locations: Philadelphia, PA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael D Walinsky, DPM | Podiatrist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Podiatrist
- Philadelphia, PA
- NPI 1760668438
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1063419117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6836 ROOSEVELT BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191492411",
"telephone_number": "214-471-0433",
"fax_number": "215-471-0430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4715 PINE ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191431831",
"telephone_number": "215-471-0433",
"fax_number": "215-471-0430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUSTIG",
"first_name": "ERIC",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-05",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "PA",
"license": "SC002614L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA. BLUE SHIELD",
"identifier": "LU1436109",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.