Individual provider Active NPI

Henry Carlton Lusane Jr., M.D.

  • Diagnostic Radiology Physician
  • Montgomery, AL
National Provider Identifier
1184690893
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
00025129 Issued in AL
Practice address
2055 Normandie Dr
Montgomery, AL 36111-2732
Phone
(334) 288-4624
Fax
(334) 280-3628
NPI assigned
Feb 23, 2006
Last updated
Sep 26, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 00025129 AL Primary

Addresses

Primary practice location

2055 Normandie Dr
Montgomery, AL 36111-2732

Mailing address

2055 Normandie Dr
Montgomery, AL 36111-2732
Phone (334) 288-4624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 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

Enrollment IDStateProvider typePAC IDDetails
I20060801000150 FL Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 5395758726 Reassigns benefits to 2 organizations
I20060928000178 AL Practitioner - Diagnostic Radiology 5395758726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of South Alabama College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of Pensacola PAGroup PAC ID 0749240836, 20 clinicians

Practice addresses (Care Compare)

1110 Gulf Breeze Pkwy
Gulf Breeze, FL 32561-4884
Phone (850) 934-2000

121 Baptist Way
Pensacola, FL 32503-2254
Phone (850) 434-4011

123 Baptist Way
Pensacola, FL 32503-2254
Phone (448) 227-3400

1301 Belleville Ave
Brewton, AL 36426-1306
Phone (850) 438-6784

1360 Brickyard Rd
Chipley, FL 32428-6303
Phone (850) 638-1610

14114 Alabama St
Jay, FL 32565-1219
Phone (850) 675-8000

475 James River Rd
Gulf Breeze, FL 32561-4868
Phone (850) 432-6851

5100 N 12TH Ave
Pensacola, FL 32504-8919
Phone (850) 432-6851

8333 N Davis Hwy
Pensacola, FL 32514-6050
Phone (850) 474-8000

8383 N Davis Hwy
Pensacola, FL 32514-6039
Phone (850) 494-4000

8888 Navarre Pkwy
Navarre, FL 32566-3615
Phone (850) 939-4888

9400 University Pkwy
Pensacola, FL 32514-5752
Phone (850) 208-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00025129ALMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of Pensacola, PA Diagnostic Radiology CurrentSince Oct 1, 2008 Accepting new patients
West Florida Medical Center Clinic, PA CurrentSince Dec 4, 2008 Accepting new patients
West Florida Medical Center Clinic PA Past Accepting new patients
Washington County Healthcare Authority, Inc Past Accepting new patients

Locations

1301 Belleville Ave
Brewton, AL 36426
Phone (251) 809-8439

14114 Alabama St
Jay, FL 32565
Phone (850) 675-8000

1717 N E St
Ste 300
Pensacola, FL 32501
Phone (850) 444-4741

5330 N Davis Hwy
Pensacola, FL 32503
Phone (850) 469-2319

8333 N Davis Hwy
Pensacola, FL 32514
Phone (850) 474-8000

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1184690893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 NORMANDIE DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361112732",
            "telephone_number": "334-288-4624",
            "fax_number": "334-280-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 NORMANDIE DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361112732",
            "telephone_number": "334-288-4624",
            "fax_number": "334-280-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSANE",
        "first_name": "HENRY",
        "middle_name": "CARLTON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "00025129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.