Individual provider Active NPI

Noa Lustgarten, PT

  • Physical Therapist
  • Brookline, MA
National Provider Identifier
1366086407
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
21022 Issued in MA
Practice address
1330 Beacon St Ste 209
Brookline, MA 02446-3202
Phone
(857) 990-6111
NPI assigned
Nov 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 21022 MA
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 21022 MA
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 21022 MA
Pain Medicine Physician 208VP0000X 21022 MA
Physical Therapist 225100000X 21022 MA Primary

Addresses

Primary practice location

1330 Beacon St Ste 209
Brookline, MA 02446-3202

Mailing address

1330 Beacon St Ste 209
Brookline, MA 02446-3202
Phone (857) 990-6111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21022MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1366086407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 BEACON ST STE 209",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463202",
            "telephone_number": "857-990-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 BEACON ST STE 209",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463202",
            "telephone_number": "857-990-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTGARTEN",
        "first_name": "NOA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "21022",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MA",
            "license": "21022",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "MA",
            "license": "21022",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MA",
            "license": "21022",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "21022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; 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.