Individual provider Active NPI

Lukasz Swistun, M.D.

  • Plastic Surgery Physician
  • La Jolla, CA
National Provider Identifier
1902083140
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A149403 Issued in CA
Practice address
9850 Genesee Ave Ste 130
La Jolla, CA 92037-1206
Phone
(858) 452-1981
NPI assigned
Jan 30, 2008
Last updated
May 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A149403 CA Primary

Addresses

Primary practice location

9850 Genesee Ave Ste 130
La Jolla, CA 92037-1206

Mailing address

9850 Genesee Ave Ste 130
La Jolla, CA 92037-1206
Phone (858) 452-1981

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180719000898 CA Practitioner - Plastic and Reconstructive Surgery 4183841240 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A149403CAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
George Orloff, MD Inc Multi-Specialty CurrentSince Jul 2, 2018 Accepting new patients
Kiersten L Riedler MD Corp Multi-Specialty CurrentSince Jun 4, 2023 Accepting new patients

Locations

2301 W Alameda Ave
Burbank, CA 91506
Phone (818) 848-0590

9850 Genesee Ave
Ste 130
La Jolla, CA 92037
Phone (858) 245-6550

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1902083140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE STE 130",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371206",
            "telephone_number": "858-452-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE STE 130",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371206",
            "telephone_number": "858-452-1981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWISTUN",
        "first_name": "LUKASZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-30",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A149403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.