Individual provider Active NPI

Penny Lustig, M.D.

  • Diagnostic Radiology Physician
  • Bedford Hills, NY
National Provider Identifier
1710960133
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
156163 Issued in NY
Practice address
52 Main St
Bedford Hills, NY 10507-1814
Phone
(914) 666-2220
Fax
(914) 666-2987
NPI assigned
Nov 21, 2005
Sex
Female
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
Diagnostic Radiology Physician 2085R0202X 156163 NY Primary

Addresses

Primary practice location

52 Main St
Bedford Hills, NY 10507-1814

Mailing address

52 Main St
Bedford Hills, NY 10507-1814
Phone (914) 666-2220

Other identifiers 1

IdentifierTypeStateIssuer
01044128MedicaidNY

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
I20040504000553 NY Practitioner - Diagnostic Radiology 0446248959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

815 Broadway
Brooklyn, NY 11206-5318
Phone (718) 388-5889

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Aug 24, 2021 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Aug 24, 2021 Accepting new patients
Sancor Medical Enterprises, LLC Diagnostic Radiology Past Accepting new patients
Pension Committee Joint Industry Board Past Accepting new patients
Advanced Imaging and Radiology Assoc Diagnostic Radiology Past Accepting new patients
Queens Long Island Medical Group, P.C. Past Accepting new patients
NPI 1003803784 Diagnostic Radiology Past Accepting new patients

Locations

815 Broadway
Brooklyn, NY 11206
Phone (646) 614-8200

50 Water St
Fl 3
New York, NY 10004

227 Madison St
New York, NY 10002
Phone (212) 238-7000

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710960133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 MAIN ST",
            "city": "BEDFORD HILLS",
            "state": "NY",
            "postal_code": "105071814",
            "telephone_number": "914-666-2220",
            "fax_number": "914-666-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 MAIN ST",
            "city": "BEDFORD HILLS",
            "state": "NY",
            "postal_code": "105071814",
            "telephone_number": "914-666-2220",
            "fax_number": "914-666-2987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTIG",
        "first_name": "PENNY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "156163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01044128",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford Hills, NY

Sources for this page

Verify at the official NPI Registry.