Alice S Lusk, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01050252A Issued in IN

Practice address

211 N Eddy St
South Bend, IN 46617-2808

Phone

(574) 232-3327

Fax

(574) 232-3369

NPI assigned

Oct 26, 2005

Last updated

Apr 5, 2020By the provider in NPPES

Sex

Female

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 1

Other names 1

• Alice H Isaacson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Purdue University

  dba Purdue University Student Health Center

  • Student Health Clinic/Center
  • West Lafayette, IN
  • NPI 1346239696
  NPD (past)

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586044800000",
    "number": "1487644845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172808",
            "telephone_number": "574-232-3327",
            "fax_number": "574-232-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172808",
            "telephone_number": "574-232-3327",
            "fax_number": "574-232-3369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSK",
        "first_name": "ALICE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2020-04-05",
        "certification_date": "2020-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01050252A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200209940",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICE",
            "last_name": "ISAACSON",
            "middle_name": "H",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gail S Lukasiewicz, NP
• Chelsey Luke, MS
• Wen Sun Lum, MD
• Amanda Lundberg, MSN, RN, FNP-BC
• Enid S Lusagala, MSW
• Carol D Luzzi, MD
• Ember Lynch-Sailors
• Kimberly Y Lynch, MA, LCSW
• Jessica Jeanette Lynton
• Carlton L. Lyons, M.D.

• Internal Medicine Physician in South Bend, IN
• Providers in South Bend, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.