Justin Lunderberg, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

125.072464 Issued in IL

Practice address

2650 Ridge Ave Ste 1304
Evanston, IL 60201-1700

Phone

(847) 570-2700

NPI assigned

Jun 28, 2018

Sex

Male

Sole proprietor

No

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 MA

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

Anesthesiology

Education

University of Chicago, Pritzker School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associated Physicians of Harvard Medical Faculty Physicians at Beth IsGroup PAC ID 6305749987, shared by 7 NPIs, 566 clinicians

Jordan Physician Associates IncGroup PAC ID 1254321086, 166 clinicians

Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, shared by 12 NPIs, 1,693 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
• Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jlunderberg251897@direct.bilh.masshiway.net

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.

• Jordan Physician Associates, Inc.

  • Family Medicine Physician
  • Plymouth, MA
  • NPI 1538145131

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Associated Physicians of Harvard Medical Faculty Physicians at Beth Is

  • Diagnostic Radiology Physician
  • Milton, MA
  • NPI 1245773308
  Medicare reassignment NPD
• Associated Physicians of Harvard Medical Faculty Physicians at Beth Is

  • Emergency Medical Services (Emergency Medicine) Physician
  • Boston, MA
  • NPI 1952358533
  Medicare reassignment NPD
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Anesthesiology Physician
  • Boston, MA
  • NPI 1093756629
  Medicare reassignment NPD
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1194765438
  Medicare reassignment NPD
• Associated Physicians of Harvard Medical Faculty Physicians at Beth Is

  • Multi-Specialty Clinic/Center
  • Boston, MA
  • NPI 1861216038
  NPD
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Emergency Medicine Physician
  • Boston, MA
  • NPI 1316987993
  NPD
• Jordan Physician Associates, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Plymouth, MA
  • NPI 1194263186
  NPD
• Beth Israel Deaconess Hospital Plymouth, Inc.

  • General Acute Care Hospital
  • Plymouth, MA
  • NPI 1043299001
  NPD (past)

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

• Beth Israel Deaconess Hospital Plymouth, Inc.

  • General Acute Care Hospital
  • Plymouth, MA
  • NPI 1043299001
  Care Compare affiliation
• Beth Israel Deaconess Medical Center, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1548202641
  Care Compare affiliation

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1245725563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1304",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDERBERG",
        "first_name": "JUSTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.072464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lumen Optical Illinois 2, LLC
• Luminessence Counseling PLLC
• Ash Luna, LCSW
• Jessica Brittany Luna, PTA
• Lunare Wellness LLC
• Rachel I Lurie, MS, LCPC, CADC
• Christine Marie Lustig, RN
• Luxottica of America Inc
• Robyne Luzietti, LCSW
• Lydia Home Association

• Internal Medicine Physician in Evanston, IL
• Providers in Evanston, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.