Individual provider Active NPI

Stewart J Lustik, M.D.

  • Anesthesiology Physician
  • Rochester, NY
National Provider Identifier
1184642787
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
179369 Issued in NY
Practice address
601 Elmwood Ave
Box 604
Rochester, NY 14642-0001
Phone
(585) 275-5982
Fax
(585) 756-0169
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 179369 NY Primary

Addresses

Primary practice location

601 Elmwood Ave
Box 604
Rochester, NY 14642-0001

Mailing address

601 Elmwood Ave
Box 604
Rochester, NY 14642-0001
Phone (585) 275-5982

Other identifiers 10

IdentifierTypeStateIssuer
P010179369OtherNYBLUE CHOICE
050029509OtherNYRAILROAD MEDICARE
2222OtherNYBLUE SHIELD GROUP
G0189393590OtherNYBLUE CHOICE GROUP
00372225MedicaidNY
01459347MedicaidNY
4631743OtherNYAETNA
00040213601OtherNYUNIVERA #
000912295001OtherNYBS WNY/HEALTHNOW
MDA552OtherNYPREFERRED CARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address slustik4546@direct.urmc.rochester.edu Direct
Direct Messaging Address slustik4546@direct.urmc.rochester.edu Direct

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
I20110215000660 NY Practitioner - Anesthesiology 2769662279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Rochester School of Medicine and Dentistry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
U of R Anesthesiology GroupGroup PAC ID 3476451105, 340 clinicians

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 275-2141

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
179369NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
U of R Anesthesiology Group Anesthesiology CurrentSince Jan 1, 1994 Accepting new patients

Locations

601 Elmwood Ave
#604
Rochester, NY 14642
Phone (585) 275-2141

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1184642787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 604",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-5982",
            "fax_number": "585-756-0169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 604",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-5982",
            "fax_number": "585-756-0169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTIK",
        "first_name": "STEWART",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "179369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P010179369",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050029509",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP",
            "identifier": "2222",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE GROUP",
            "identifier": "G0189393590",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00372225",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01459347",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4631743",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA #",
            "identifier": "00040213601",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS WNY/HEALTHNOW",
            "identifier": "000912295001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "MDA552",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slustik4546@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slustik4546@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.