Individual provider Active NPI

Bryan Elliot Lusk, M.D.

  • Ophthalmology Physician
  • Shreveport, LA
National Provider Identifier
1700043643
Registry record updated Apr 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
203516 Issued in LA
Practice address
451 Ashley Ridge Blvd
Shreveport, LA 71106-7229
Phone
(318) 222-5555
Fax
(318) 222-6414
NPI assigned
May 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 203516 LA Primary
Ophthalmology Physician 207W00000X 62138 GA

Addresses

Primary practice location

451 Ashley Ridge Blvd
Shreveport, LA 71106-7229

Mailing address

451 Ashley Ridge Blvd
Shreveport, LA 71106-7229
Phone (318) 222-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20110124001038 LA Practitioner - Ophthalmology 2860559580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lusk Eye Specialists, LLCGroup PAC ID 6901792985, 7 clinicians

Practice addresses (Care Compare)

3 Medical Plaza PL
Minden, LA 71055-3330
Phone (318) 222-5555

451 Ashley Ridge Blvd
Shreveport, LA 71106-7229
Phone (318) 222-5555

Hospital & facility affiliations

  • Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery610

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62138GAMDOphthalmology Physician
203516LAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laser & Cataract Center of Shreveport LLC Current Accepting new patients

Locations

445 Ashley Ridge Blvd
Shreveport, LA 71106
Phone (318) 869-1130

Interoperability endpoints

  • Direct secure messaging: minblusk@yourcarecommunity.org

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270598400000",
    "number": "1700043643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 ASHLEY RIDGE BLVD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067229",
            "telephone_number": "318-222-5555",
            "fax_number": "318-222-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 ASHLEY RIDGE BLVD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067229",
            "telephone_number": "318-222-5555",
            "fax_number": "318-222-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSK",
        "first_name": "BRYAN",
        "middle_name": "ELLIOT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-19",
        "last_updated": "2010-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "203516",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "62138",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.