Michael J Lyster IV, D.O.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

34005911 Issued in OH

Practice address

703 Tyler St
Suite 250
Sandusky, OH 44870-3367

Phone

(440) 414-9300

Fax

(216) 201-5588

NPI assigned

Jan 13, 2006

Last updated

Jan 7, 2021By the provider in NPPES

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

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Randall C Orem DO Inc

  dba Advanced Cardiovascular Services

  • Cardiovascular Disease Physician
  • Sidney, OH
  • NPI 1659542322
  NPD (past)

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1295714590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 TYLER ST",
            "address_2": "SUITE 250",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448703367",
            "telephone_number": "440-414-9300",
            "fax_number": "216-201-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 TYLER ST",
            "address_2": "SUITE 250",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448703367",
            "telephone_number": "440-414-9300",
            "fax_number": "216-201-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYSTER",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "34005911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "85116",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "341221800115",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060063317",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000193314",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michaellyster@nohomg.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "703 Tyler St",
            "address_2": "Suite 250",
            "city": "Sandusky",
            "state": "OH",
            "country_code": "US",
            "postal_code": "448703367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lutheran Memorial Home
• Sheena P Lutz
• Melissa Lyle, SLP
• Brianna Lynn
• Sarah Marie Lynn, RN
• M D Cooper Inc.
• Alivia Mae Macdonald, MA CCC-SLP
• Jared R. Macdonald
• Karen Lynn Machovina, LPN
• Morgan Maclean-Beran, DPM

• Cardiovascular Disease Physician in Sandusky, OH
• Providers in Sandusky, OH by specialty
• Cardiovascular Disease Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.