Tristan Roman Lubina

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

12345127-4405 Issued in UT

Practice address

1501 University VLG
Salt Lake City, UT 84108-3522

Phone

(801) 587-7000

NPI assigned

Mar 7, 2021

Last updated

Jul 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ma Bo Inc

  dba House Call Doctors

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1740461219
  Medicare reassignment NPD
• Ma Bo Inc

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1588185581
  NPD

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

{
    "created_epoch": "1615075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1699360065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 ROUND VALLEY DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 UNIVERSITY VLG",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841083522",
            "telephone_number": "801-587-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBINA",
        "first_name": "TRISTAN",
        "middle_name": "ROMAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-07",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "UT",
            "license": "10670291-3102",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "12345127-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ree Lu, MD
• Tyehao M Lu, L.AC, MAOM
• Ryli Lua
• Noah Burt Lubben
• Jade Lubeck
• Kristine Louise Lublin, LPC
• Fabiola Lucas
• Melanie Lucas
• Sean P Lucas, DDS
• Amanda C Lucero, ND

• Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.