Peter L Lusich IV, M.D

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

11770 Issued in NV

Practice address

2865 Daggett Ave
Klamath Falls, OR 97601-1106

Phone

(541) 882-6311

Fax

(775) 883-0797

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV, OR2 enrollments

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 2

Specialty

Anesthesiology

Education

University of Nevada School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Salem Hospital Hospital, Salem, OR, CCN 380051
• Sky Lakes Medical Center Hospital, Klamath Falls, OR, CCN 380050

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Medicare reassignment Care Compare group NPD
• Lusich Anesthesia Consultants

  • Anesthesiology Physician
  • Carson City, NV
  • NPI 1063703296
  NPD (past) Authorized official
• Salem Health

  • Durable Medical Equipment & Medical Supplies
  • Keizer, OR
  • NPI 1487434775
  NPD
• Northern Nevada Anesthesia Associates PLLC

  • Anesthesiology Physician
  • Carson City, NV
  • NPI 1760705164
  NPD (past)
• Sheridan Drozdow Healthcare of Nevada PC

  • Anesthesiology Physician
  • Las Vegas, NV
  • NPI 1003019266
  NPD (past)

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

• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Care Compare affiliation
• Sky Lakes Medical Center Inc

  • Occupational Therapist
  • Klamath Falls, OR
  • NPI 1134270911

  Hospital

  Care Compare affiliation
• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Care Compare affiliation

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1093735342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1359",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976010075",
            "telephone_number": "541-882-1540",
            "fax_number": "541-882-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-882-6311",
            "fax_number": "775-883-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSICH",
        "first_name": "PETER",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "11770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Anesthesiology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.