Individual provider Active NPI

Eliyahu Lustiger, M.D.

  • Emergency Medicine Physician
  • New Brunswick, NJ
National Provider Identifier
1245604198
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MA09813300 Issued in NJ
Practice address
254 Easton Avenue
Department of Emergency Services
New Brunswick, NJ 08901
Phone
(732) 235-4296
NPI assigned
Nov 16, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA09813300 NJ Primary

Addresses

Primary practice location

254 Easton Avenue
Department of Emergency Services
New Brunswick, NJ 08901

Mailing address

1 Robert Wood Johnson PL
Meb 588a
New Brunswick, NJ 08901-1928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20160328001409 NJ Practitioner - Emergency Medicine 4688971120 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Bank Emergency Physicians LLC Emergency Medicine CurrentSince Feb 13, 2016 Accepting new patients

Locations

254 Easton Ave
New Brunswick, NJ 08901
Phone (732) 565-5453

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1245604198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ROBERT WOOD JOHNSON PL",
            "address_2": "MEB 588A",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 EASTON AVENUE",
            "address_2": "DEPARTMENT OF EMERGENCY SERVICES",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "08901",
            "telephone_number": "732-235-4296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTIGER",
        "first_name": "ELIYAHU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-16",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA09813300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.