Individual provider Active NPI

Mary F Lustig, AUD

  • Audiologist
  • Holland, MI
National Provider Identifier
1801909452
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1601000125 Issued in MI
Practice address
399 E 32ND St Ste 70
Holland, MI 49423-5518
Phone
(616) 392-2222
Fax
(616) 499-7229
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 1601000125 MI
Audiologist 231H00000X 1601000125 MI Primary

Addresses

Primary practice location

399 E 32ND St Ste 70
Holland, MI 49423-5518

Mailing address

577 Michigan Ave
Suite 101
Holland, MI 49423-4911
Phone (616) 393-2190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080603000592 MI Practitioner - Qualified Audiologist 9931279965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holland Audiology PLLCGroup PAC ID 9537312780, 3 clinicians

Practice addresses (Care Compare)

399 E 32ND St
Holland Doctors of Audiology
Holland, MI 49423-5518
Phone (616) 392-2222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1601000125MIMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Audiology, PLLC Audiologist CurrentSince Jul 17, 2025 Accepting new patients

Locations

399 E 32nd St
Holland, MI 49423
Phone (616) 392-2222

399 E 32nd St
Ste 70
Holland, MI 49423
Phone (616) 392-2222

Organizations & group practices 1

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1801909452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 MICHIGAN AVE",
            "address_2": "SUITE 101",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234911",
            "telephone_number": "616-393-2190",
            "fax_number": "616-393-0147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 E 32ND ST STE 70",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494235518",
            "telephone_number": "616-392-2222",
            "fax_number": "616-499-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTIG",
        "first_name": "MARY",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MI",
            "license": "1601000125",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "1601000125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.