Active NPI
Micah Danielle Lust, PA-C
- Medical Physician Assistant
- Lubbock, TX
National Provider Identifier
1295987410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA05964
- Practice address
- 5004 122ND St Ste 200
Lubbock, TX 79424-8398 - Phone
- (469) 734-8689
- NPI assigned
- Oct 21, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA05964 | TX | Primary |
Addresses
Primary practice location
5004 122ND St Ste 200
Lubbock, TX 79424-8398
Mailing address
7008 Indiana Ave
Ste. a
Lubbock, TX 79413-6114
Phone (806) 698-8088
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Texas Tech University Health Science Center School of Medicine, 2008
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
11007 Quaker Ave
Lubbock, TX 79424-8317
Phone (806) 701-4040
Hospital & facility affiliations
- Covenant Childrens Hospital
- University Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.52 of 100
- Quality
- 87.98
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA05964 | TX | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Management Services of Texas II, LLC | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Lubbock, TX
- NPI 1679011621
-
- Family Medicine Physician
- Lubbock, TX
- NPI 1831750553
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Ambulatory Surgical Clinic/Center
- Lubbock, TX
- NPI 1538245717
Hospital
-
- General Acute Care Hospital
- Lubbock, TX
- NPI 1821087164
-
- Hearing and Speech Clinic/Center
- Lubbock, TX
- NPI 1831299114
Hospital
-
- Children's Hospital
- Lubbock, TX
- NPI 1437171568
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669680000000",
"number": "1295987410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7008 INDIANA AVE",
"address_2": "STE. A",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794136114",
"telephone_number": "806-698-8088",
"fax_number": "806-698-8588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5004 122ND ST STE 200",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794248398",
"telephone_number": "469-734-8689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUST",
"first_name": "MICAH",
"middle_name": "DANIELLE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-21",
"last_updated": "2022-11-29",
"certification_date": "2022-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "PA05964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.