Active NPI
Jefferson Lustre
- Student in an Organized Health Care Education/Training Program
- Baltimore, MD
National Provider Identifier
1760293062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 9101 Franklin Square Dr Ste 300
Baltimore, MD 21237-3966 - Phone
- (443) 777-6545
- NPI assigned
- Jan 15, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
9101 Franklin Square Dr Ste 300
Baltimore, MD 21237-3966
Mailing address
127 W Goodheart Ave
Lake Mary, FL 32746-2705
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781654400000",
"number": "1760293062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 W GOODHEART AVE",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327462705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9101 FRANKLIN SQUARE DR STE 300",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212373966",
"telephone_number": "443-777-6545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUSTRE",
"first_name": "JEFFERSON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-01-15",
"last_updated": "2026-06-17",
"certification_date": "2026-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
- Zoe I Luscher, MD
- Dina Lusiku
- Lustman-Cohen Dental, LLC (Drs. Lustman & Cohen)
- Mark Allan Lustman, D.D.S.
- Rebecca Lustman, PHARMD
- Rachel Luthcke, MD
- Lutheran Mission Society of Maryland (Compassionate Grace Counseling Center)
- Lutherville Hematology and Oncology
- Alexandra Baker Lutz, MD
- Gabriel Lutz, MD, PHD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.