Active NPI
John Ekstrom Lusche, M.D.
- Orthopaedic Surgery Physician
- Pasadena, CA
National Provider Identifier
1235144882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- G7035
- Practice address
- 100 W California Blvd
Pasadena, CA 91105-3010 - Phone
- (626) 397-5000
- Fax
- (626) 397-2912
- NPI assigned
- Jul 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | G7035 | CA | Primary |
Addresses
Primary practice location
100 W California Blvd
Pasadena, CA 91105-3010
Mailing address
225 S Lake Ave
535
Pasadena, CA 91101-3005
Phone (626) 795-6596
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G70350 | Other | CA | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G7035 | CA | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212710400000",
"number": "1235144882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 S LAKE AVE",
"address_2": "535",
"city": "PASADENA",
"state": "CA",
"postal_code": "911013005",
"telephone_number": "626-795-6596",
"fax_number": "626-795-8247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 W CALIFORNIA BLVD",
"city": "PASADENA",
"state": "CA",
"postal_code": "911053010",
"telephone_number": "626-397-5000",
"fax_number": "626-397-2912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUSCHE",
"first_name": "JOHN",
"middle_name": "EKSTROM",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-30",
"last_updated": "2008-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "G7035",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00G70350",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.