Tri-State Urology

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD031897E Issued in PA

Legal business name

TRI-STATE UROLOGY

Practice address

16844 Saint Clair Ave
East Liverpool, OH 43920-4277

Phone

(330) 385-1770

Fax

(724) 728-9722

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael Lane Lustbader, M.D.NPI 1518923150

Title

Doctor

Phone

(724) 728-4224

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael L Lustbader, M.D.

  • Specialist
  • Beaver, PA
  • NPI 1518923150
  NPD Authorized official

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200614400000",
    "number": "1801995766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PEARTREE WAY",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150091954",
            "telephone_number": "724-728-4224",
            "fax_number": "724-728-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16844 SAINT CLAIR AVE",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "439204277",
            "telephone_number": "330-385-1770",
            "fax_number": "724-728-9722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE UROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-01-18",
        "status": "A",
        "authorized_official_last_name": "LUSTBADER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LANE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "724-728-4224",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "PA",
            "license": "MD031897E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014509850001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CL4084",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tri County Ambulance Inc.
• Tri State Cab Co, LLC
• Tri State Lung & Sleep Associates, Inc
• Tri- State Emergency Physicians Inc
• Tri-State Regional Cancer Center
• Trinity Recovery,LLP
• Richard A Troisi
• Marissa Lee Trzaskoma, APRN
• Tudor Home Therapies, Inc
• Kristy Lynn Tuttle, PHARMD

• Urology Physician in East Liverpool, OH
• Providers in East Liverpool, OH by specialty
• Urology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.