Jonathan Jerome Lusardi, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

2016009655 Issued in MO

Practice address

12255 Depaul Dr 830N
Bridgeton, MO 63044

Phone

(314) 291-5307

Fax

(314) 291-0838

NPI assigned

Jun 26, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Otolaryngology

Education

Saint Louis University School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic ENT LLCGroup PAC ID 7517118813, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
• Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Mercy Clinic ENT LLC

  • Otolaryngology Physician
  • Washington, MO
  • NPI 1366705998

  MO, Otolaryngology

  Medicare reassignment Care Compare group NPD
• University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1245541176
  NPD (past)

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

• Mercy Hospital South

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1568481984

  Hospital

  Care Compare affiliation
• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169

  Hospital

  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1309046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1487940672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12255 DEPAUL DR SUITE 830N",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442510",
            "telephone_number": "314-291-5307",
            "fax_number": "314-291-0838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12255 DEPAUL DR 830N",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "63044",
            "telephone_number": "314-291-5307",
            "fax_number": "314-291-0838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSARDI",
        "first_name": "JONATHAN",
        "middle_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-26",
        "last_updated": "2021-04-27",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "2016009655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xinrong Lu, M.D.
• Kayla Lucas, LMSW
• Marc Luckett, M.D.
• Casie Ludwig
• Kelty Lufcy, M.A.
• Kimberly L. Luu, PA
• Luxottica of America Inc
• Morgan Lyle
• Jillian Lynum
• Matthew B Lytle, D.C.

• Otolaryngology Physician in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Otolaryngology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.