Individual provider Active NPI

Stuart A. Lustberg, M.D.

  • Obstetrics & Gynecology Physician
  • Huntington, NY
National Provider Identifier
1528120102
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
182725 Issued in NY
Practice address
110 E Main St
Suite 3
Huntington, NY 11743-2845
Phone
(631) 421-4100
Fax
(631) 421-5336
NPI assigned
Dec 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 182725 NY Primary

Addresses

Primary practice location

110 E Main St
Suite 3
Huntington, NY 11743-2845

Mailing address

110 E Main St
Suite 3
Huntington, NY 11743-2845
Phone (631) 421-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20120105000009 NY Practitioner - Obstetrics/Gynecology 6002082591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of New York at Stony Brook, School of Medicine, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

110 E Main St
Suite 3
Huntington, NY 11743-2845
Phone (631) 421-4100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Huntington Bay Obstetrics & Gynecology, P.C. Obstetrics & Gynecology CurrentSince Oct 1, 1984 Accepting new patients
Huntington Hospital Dolan Family Health Center PastSince Jun 7, 2024 Accepting new patients

Locations

110 E Main St
Ste 3
Huntington, NY 11743
Phone (631) 421-4100

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528120102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E MAIN ST",
            "address_2": "SUITE 3",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432845",
            "telephone_number": "631-421-4100",
            "fax_number": "631-421-5336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E MAIN ST",
            "address_2": "SUITE 3",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432845",
            "telephone_number": "631-421-4100",
            "fax_number": "631-421-5336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTBERG",
        "first_name": "STUART",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "182725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.