Annette Lusko, D.O
Individual provider Active NPI Family Medicine Physician · Mesa, AZ
NPI 1487918181 · NPPES record last updated May 8, 2018
Key facts
- NPI
- 1487918181
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 006726 (AZ)
- Practice address
- 1855 W Baseline Rd Ste 101
Mesa, AZ 85202-9098 - Phone
- (480) 507-3188
- NPI assigned
- Jun 27, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 22
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Community Bridges Inc
Practice addresses (Care Compare)
2770 E Van Buren St
RM Abd
Phoenix, AZ 85008-6088
Phone (602) 273-9999
35 K St NE
Washington, DC 20002-4216
Phone (202) 839-3500
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AZ, DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150819008305 | AZ | Practitioner - Family Practice | 9335394600 | Reassigns benefits to 3 organizations |
| I20240806004504 | DC | Practitioner - Family Practice | 9335394600 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006726 | AZ | MD | Family Medicine Physician |
| 11016763A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Bridges, Inc. | Current |
Accepting new patients | |
| Community Bridges, Inc | Current | Accepting new patients | |
| Community Bridges, Inc. | Current |
Accepting new patients | |
| Community Bridges, Inc. | Current |
Accepting new patients | |
| Teris Health Services LLC | Current |
Accepting new patients | |
| Community Bridges, Inc. | Current | Accepting new patients | |
| Community Bridges, Inc. | Current |
Accepting new patients | |
| Teri'S Health Services | Current |
Accepting new patients | |
| Community Bridges, Inc. | Current | Accepting new patients | |
| Heritage Technologies, LLC | Family Medicine | Current |
Accepting new patients |
| Florence Unified School District | Past |
Accepting new patients | |
| Horizon Health and Wellness, Inc. | Past | Accepting new patients | |
| RHG of Arizona, PC | Family Medicine | Past |
Accepting new patients |
| Tri-City Express Care, PLLC | Family Medicine | Past | Accepting new patients |
| Community Bridges, Inc. | Past | Accepting new patients | |
| Community Bridges, Inc. | Past |
Accepting new patients | |
| Community Bridges, Inc. | Past | Accepting new patients | |
| Horizon Health & Wellness, Inc. | Past | Accepting new patients | |
| Community Bridges, Inc. | Past |
Accepting new patients | |
| Horizon Health and Wellness, Inc. | Past | Accepting new patients | |
| Florence Unified School District #1 | Past | Accepting new patients | |
| Community Bridges, Inc. | Past | Accepting new patients |
Locations
5656 S Power Rd
Ste 126
Gilbert, AZ 85295
993 Hermosa Dr
#B
Holbrook, AZ 86025
Phone (928) 524-1151
554 S Bellview
Rm A
Mesa, AZ 85204
1855 N Stapley Dr
Mesa, AZ 85203
Phone (480) 545-0031
10238 E Hampton Ave
Ste 508
Mesa, AZ 85209
Phone (480) 358-6187
1855 W Baseline Rd
Ste 101
Mesa, AZ 85202
2770 E Van Buren St
Rm A
Phoenix, AZ 85008
Phone (602) 273-9999
2770 E Van Buren St
Rm Abd
Phoenix, AZ 85008
Phone (602) 273-9999
14040 N Cave Creek Rd
Ste 205
Phoenix, AZ 85022
Phone (602) 358-7073
1520 E Pima St
Phoenix, AZ 85034
Phone (480) 232-8325
250 S Toole Ave
Ste A
Tucson, AZ 85701
Phone (520) 323-1312
110 E Second St
Winslow, AZ 86047
Phone (928) 289-1122
3180 E 40th St
Yuma, AZ 85365
Phone (928) 341-0335
35 K St NE
Washington, DC 20002
Phone (202) 442-4202
Interoperability endpoints
- annette.luskodo.p1@direct.cbridges.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 11016763A | IN | |
| Family Medicine Physician | 207Q00000X | 006726 | AZ | Yes |
Addresses
Primary practice location
1855 W Baseline Rd Ste 101
Mesa, AZ 85202-9098
Mailing address
1855 W Baseline Rd Ste 101
Mesa, AZ 85202-9098
Phone (480) 390-1085
Other providers in Mesa, AZ
- Minh Tran Luong
- Priscilla Marie Luong
- Joanne Kirsten Lupe
- Michelle D Lupien
- Lupine Solutions Corp
- Douglas Lusko
- Lutheran Association of Missionaries and Pilots U.S., Inc.
- Susan Diane Luttjohann
- Robert Lutton
- Lutz Get Healthy LLC
All providers in Mesa, AZ · Family Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.