Individual provider Active NPI

Kristen Lu, MD

  • Psychiatry Physician
  • Springfield, IL
National Provider Identifier
1790346682
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
332806 Issued in NY
Practice address
319 E Madison St FL 3
Springfield, IL 62701-1035
Phone
(217) 545-8229
Fax
(217) 545-2275
NPI assigned
Jun 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA12412100 NJ
Psychiatry Physician 2084P0800X 332806 NY Primary
Internal Medicine Physician 207R00000X 332806 NY
Psychiatry Physician 2084P0800X 25MA12412100 NJ
Internal Medicine Physician 207R00000X 036169928 IL
Psychiatry Physician 2084P0800X 036169928 IL

Addresses

Primary practice location

319 E Madison St FL 3
Springfield, IL 62701-1035

Mailing address

PO Box 19642
Springfield, IL 62794-9642
Phone (217) 545-8229

Other practice location 1

375 Seguine Ave
Staten Island, NY 10309-3932
Phone (718) 226-2000

Other practice location 2

268 Canal St
New York, NY 10013-3599
Phone (212) 941-2213

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
I20260414001165 NY Practitioner - PsychiatryPractitioner - Internal Medicine 5193050649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Internal Medicine
Education
Northeastern Ohio University College of Medicine, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

2 Brighton Rd
Suite 300
Clifton, NJ 07012-1645

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125074993ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University Past Accepting new patients
St Josephs Hospital Yonkers Past Accepting new patients

Organizations & group practices 3

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": "1561161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1790346682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19642",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949642",
            "telephone_number": "217-545-8229",
            "fax_number": "217-545-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 E MADISON ST FL 3",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011035",
            "telephone_number": "217-545-8229",
            "fax_number": "217-545-2275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "375 Seguine Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103093932",
            "country_code": "US",
            "telephone_number": "718-226-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "268 Canal St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100133599",
            "country_code": "US",
            "telephone_number": "212-941-2213",
            "fax_number": "212-941-2180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LU",
        "first_name": "KRISTEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-22",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA12412100",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "332806",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "332806",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA12412100",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036169928",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036169928",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.