Individual provider Active NPI

Colleen Lustina, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Crown Point, IN
National Provider Identifier
1346576998
Registry record updated Nov 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28146913A Issued in IN
Practice address
1000 S Court St
Crown Point, IN 46307-4855
Phone
(219) 757-6272
NPI assigned
Nov 2, 2009
Last updated
Nov 2, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28146913A IN Primary

Addresses

Primary practice location

1000 S Court St
Crown Point, IN 46307-4855

Mailing address

12334 Spencer PL
Crown Point, IN 46307-6602
Phone (219) 662-9614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160616000966 IN Practitioner - Nurse Practitioner 7911298211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indiana Sports and Medical Science Institute, PCGroup PAC ID 2860662517, 7 clinicians

Practice addresses (Care Compare)

11275 Delaware Pkwy
Suite a
Crown Point, IN 46307-7812
Phone (219) 779-8735

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28146913AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Sports & Medical Science Institute, PC CurrentSince Oct 2, 2019 Accepting new patients
Franciscan Health Crown Point Past Accepting new patients

Locations

11275 Delaware Pkwy
Crown Point, IN 46307
Phone (219) 779-8735

11275 Delaware Pkwy
#A
Crown Point, IN 46307
Phone (219) 662-5530

Interoperability endpoints

  • Direct secure messaging: clustina@isamsip-in.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257120000000",
    "number": "1346576998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12334 SPENCER PL",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463076602",
            "telephone_number": "219-662-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S COURT ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463074855",
            "telephone_number": "219-757-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTINA",
        "first_name": "COLLEEN",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-02",
        "last_updated": "2009-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28146913A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.