Alexander Michael Lustberg, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A86284 Issued in CA

Practice address

500 Doyle Park Dr
Suite G04
Santa Rosa, CA 95405-4558

Phone

(707) 303-8349

Fax

(707) 303-2694

NPI assigned

Jan 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

GastroenterologyAlso: Internal Medicine

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Santa Rosa Regional Hospital Hospital, Santa Rosa, CA, CCN 050291
• California Pacific Medical Ctr-Davies Campus Hosp Hospital, San Francisco, CA, CCN 050008
• Sutter Lakeside Hospital Hospital, Lakeport, CA, CCN 051329

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alustberg208993@hisp.ehr.sutterhealth.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.

• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Orinda, CA
  • NPI 1366898538
  NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Gastroenterology Medical Associates of Sonoma

  • Specialist
  • Santa Rosa, CA
  • NPI 1053449850

  Gastroenterology

  NPD (past)
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  NPD (past)
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798
  NPD (past)
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769
  NPD (past)
• Inova Health Care Services

  • General Acute Care Hospital
  • Leesburg, VA
  • NPI 1376564302
  NPD (past)
• Reston Hospital Center LLC

  • General Acute Care Hospital
  • Reston, VA
  • NPI 1053363853
  NPD (past)

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

• Sutter Bay Hospitals

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1659439834
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798
  Care Compare affiliation
• Sutter Bay Hospitals

  • Critical Access Hospital
  • Lakeport, CA
  • NPI 1952634008
  Care Compare affiliation

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1225009301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR",
            "address_2": "SUITE G04",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054558",
            "telephone_number": "707-303-8349",
            "fax_number": "707-303-2694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 Mark West Springs Rd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954031766",
            "country_code": "US",
            "telephone_number": "707-541-7900",
            "fax_number": "707-573-5411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUSTBERG",
        "first_name": "ALEXANDER",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2023-03-07",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A-86284",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A86284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A862840",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michaellustberg@sjhhandhmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "500 Doyle Park Dr",
            "address_2": "Suite G04",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954054558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Susan Lundt
• Thanh Luong, OTR/L
• James Russel Luper, MA, MFT
• Amelie Luporini, PA, RD
• Benjamin Lurie, MD
• Cameron Craig Lutchansky
• Marvin Luu
• Luxottica of America Inc.
• Luxottica of America Inc.
• Luxottica of America Inc.

• Gastroenterology Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.