Individual provider Active NPI

Michael Robert Lustig, MD

  • Family Medicine Physician
  • Newport News, VA
National Provider Identifier
1255322343
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101046649 Issued in VA
Practice address
10510 Jefferson Ave
Suite a
Newport News, VA 23601-3102
Phone
(757) 594-3800
Fax
(757) 594-3818
NPI assigned
Oct 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101046649 VA Primary

Addresses

Primary practice location

10510 Jefferson Ave
Suite a
Newport News, VA 23601-3102

Mailing address

856 J Clyde Morris Blvd
Suite a
Newport News, VA 23601-1318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20080116000534 VA Practitioner - Family Practice 9537240478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.05 of 100Reported as group
Quality
80.86
Promoting interoperability
79
Improvement activities
40
Cost
85.5

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Hospital Inc. Family Medicine CurrentSince Nov 1, 2007 Accepting new patients
Riverside Hospital Inc CurrentSince Nov 1, 2007 Accepting new patients
Riverside Hospital Inc Current Accepting new patients

Locations

10510 Jefferson Ave
Ste A
Newport News, VA 23601
Phone (757) 594-3800

610 Thimble Shoals Blvd
Ste 520
Newport News, VA 23606
Phone (804) 594-3408

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

10510 Jefferson Ave
Ste E
Newport News, VA 23601
Phone (757) 594-2846

316 Main St
#520
Newport News, VA 23601
Phone (804) 594-3408

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1255322343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD",
            "address_2": "SUITE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10510 JEFFERSON AVE",
            "address_2": "SUITE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236013102",
            "telephone_number": "757-594-3800",
            "fax_number": "757-594-3818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTIG",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-29",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101046649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.