David Michael Lustig, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

ME 128530 Issued in FL

Practice address

13933 17TH St
Suite 201
Dade City, FL 33525-4604

Phone

(352) 437-4505

Fax

(352) 437-4709

NPI assigned

Oct 17, 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

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Urology

Education

Other, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: david.lustig.1@21577.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/20634/brand/1/csg/1/fhir/r4
• Direct secure messaging: david.lustig.1@20634.direct.athenahealth.com

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.

• Central Florida Cancer Institute PA

  • Multi-Specialty Clinic/Center
  • Celebration, FL
  • NPI 1306870092

  FL

  Medicare reassignment NPD
• Inspire Medical Care PA

  • Internal Medicine Physician
  • Bradenton, FL
  • NPI 1154001907

  FL, Urology

  Medicare reassignment NPD
• Post Acute Specialists of Florida PLLC

  • Internal Medicine Physician
  • Bradenton, FL
  • NPI 1992571608

  FL, Urology

  Medicare reassignment NPD
• Central Florida Cancer Institute PA

  • Multi-Specialty Clinic/Center
  • Davenport, FL
  • NPI 1235478603
  NPD
• Florida Hospital Physician Group Inc

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1174955256
  NPD (past)
• Carolinas Medical Alliance, Inc

  • Rural Health Clinic/Center
  • Pamplico, SC
  • NPI 1023238490
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1093896367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13933 17TH ST",
            "address_2": "SUITE 201",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335254604",
            "telephone_number": "352-437-4505",
            "fax_number": "352-437-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13933 17TH ST",
            "address_2": "SUITE 201",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335254604",
            "telephone_number": "352-437-4505",
            "fax_number": "352-437-4709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTIG",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME 128530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "340018922",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "434494",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "542025035",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER",
            "identifier": "7503962",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0380470",
            "state": "VI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3433588",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDIPA",
            "identifier": "2127380",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007503962",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Dawn Lipinski
• Steven Logan, PH.D.
• Kristina May Lombardi, R.PH, PHARM.D., BCPS
• Nichole Marie Long
• Luminescence Therapy LLC
• Behrouz Madani, M.D.
• Michael L Maggard, O.D.
• Emad Mansour
• James Edward Martinez, RPH
• Nancy T Mathew

• Urology Physician in Dade City, FL
• Providers in Dade City, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.