Jacqueline O Lustig, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

041948 Issued in CT

Practice address

380 Main St
Watertown, CT 06795-2260

Phone

(860) 274-8891

Fax

(860) 274-8895

NPI assigned

Aug 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CIDIBD/Endpoint/CIDIBD
• FHIR API: https://fhir4.healow.com/fhir/r4/CIDIBD

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.

• Town and Country Pediatrics and Family Medicine, P.C.

  • Pediatrics Physician
  • Watertown, CT
  • NPI 1942414081

  Family Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245246966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 MAIN ST",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067952260",
            "telephone_number": "860-274-8891",
            "fax_number": "860-274-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 MAIN ST",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067952260",
            "telephone_number": "860-274-8891",
            "fax_number": "860-274-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTIG",
        "first_name": "JACQUELINE",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "041948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lianna Tsangarides Lindsey
• Kristine Marie Loomis, LMT
• Lotus Counseling of Connecticut LLC
• Nicholas Tyler Lucatino, BCBA
• Matoula Luis
• January Lynch, BCBA
• Marisa Lynn-Castiglia Mancini, PT, DPT
• Nicole Marcelynas, M.S., CCC-SLP
• Diana Marroquin, PT
• Nicole Martino, LPC

• Family Medicine Physician in Watertown, CT
• Providers in Watertown, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.