Individual provider Active NPI

Michael Emory Lustgarten, MD

  • Urology Physician
  • Stuart, FL
National Provider Identifier
1376525501
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME0036091 Issued in FL
Practice address
834 E Ocean Blvd
Stuart, FL 34994-2428
Phone
(772) 286-2950
Fax
(772) 286-2339
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME0036091 FL Primary

Addresses

Primary practice location

834 E Ocean Blvd
Stuart, FL 34994-2428

Mailing address

834 E Ocean Blvd
Stuart, FL 34994-2428
Phone (772) 286-2950

Other identifiers 2

IdentifierTypeStateIssuer
065662300MedicaidFL
340000180OtherFLRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100816000362 FL Practitioner - Urology 8224104971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin Memorial Medical Center IncGroup PAC ID 2961300611, 514 clinicians

Practice addresses (Care Compare)

3801 S Kanner Hwy
Suite 200
Stuart, FL 34994-4801
Phone (772) 288-5862

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, Port Saint Lucie, FL, CCN 109270
  • Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0036091FLMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Memorial Medical Center Inc Current Accepting new patients

Locations

509 SE Riverside Dr
Ste 305
Stuart, FL 34994
Phone (772) 221-2003

3801 S Kanner Hwy
Fl 2
Stuart, FL 34994
Phone (772) 223-4999

3801 S Kanner Hwy
Ste 200
Stuart, FL 34994
Phone (772) 223-4978

2150 SE Salerno Rd
Ste 200
Stuart, FL 34997
Phone (772) 223-5757

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1376525501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 E OCEAN BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942428",
            "telephone_number": "772-286-2950",
            "fax_number": "772-286-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 E OCEAN BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942428",
            "telephone_number": "772-286-2950",
            "fax_number": "772-286-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTGARTEN",
        "first_name": "MICHAEL",
        "middle_name": "EMORY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME0036091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065662300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "340000180",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.