Mark E Lustberg, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

67997 Issued in CT

Practice address

20 York St
New Haven, CT 06510-3220

Phone

(203) 688-5523

Fax

(203) 688-3216

NPI assigned

Apr 4, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CT

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

Infectious Disease

Education

University of Maryland School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
• Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mlustberg4327@direct.osumc.edu
• Direct secure messaging: mlustberg519550@direct.ynhh.org

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.

• Yale University

  • Anesthesiology Physician
  • New Haven, CT
  • NPI 1205822236
  Medicare reassignment Care Compare group NPD
• Yale University

  • Durable Medical Equipment & Medical Supplies
  • Fairfield, CT
  • NPI 1548066962
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1649260845
  Care Compare affiliation
• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1992910152
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1578778726
  Care Compare affiliation

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1104948934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 RANDI DR",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432483",
            "telephone_number": "410-375-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-5523",
            "fax_number": "203-688-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTBERG",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CT",
            "license": "67997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2954478",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlustberg4327@direct.osumc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "460 W 10th Ave Fl 5",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432101240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlustberg4327@direct.osumc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1581 Dodd Dr Fl 4",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432101257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Xuan Luo, MD
• Stephanie Lauren Luon, PHARMD, RPH
• Ashley Medley Luparia, CNM, WHNP-BC
• Elicia Lupoli, RDH
• Beatrice C Lupsa, M.D.
• Maryam Beheshti Lustberg, M.D.
• Denyse Dawn Lutchmansingh, MD
• Michele Rene Luzzi Muzyka, APRN
• Christopher Lyddy
• Eileen M Lydon, PAC

• Infectious Disease Physician in New Haven, CT
• Providers in New Haven, CT by specialty
• Infectious Disease Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.