Individual provider Active NPI

Amy B Lustig, DPM

  • Foot & Ankle Surgery Podiatrist
  • Philadelphia, PA
National Provider Identifier
1902973407
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC004390L Issued in PA
Practice address
9892 Bustleton Ave
Suite 303
Philadelphia, PA 19115-2184
Phone
(215) 673-3200
Fax
(215) 673-3884
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X SC004390L PA Primary

Addresses

Primary practice location

9892 Bustleton Ave
Suite 303
Philadelphia, PA 19115-2184

Mailing address

9892 Bustleton Ave
Suite 303
Philadelphia, PA 19115-2184
Phone (215) 673-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091116000141 PA Practitioner - Podiatry 3870631617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9892 Bustleton Ave
Suite 303
Phila, PA 19115-2140
Phone (215) 673-3200

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue12
Removal of nail tissue1488
Removal or shaving of skin growth494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC004390LPAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Family Foot Care, PC CurrentSince Nov 27, 2001 Accepting new patients

Locations

9892 Bustleton Ave
Ste 303
Philadelphia, PA 19115
Phone (215) 673-3200

9892 Bustleton Ave
Ste 301
Philadelphia, PA 19115
Phone (215) 464-4111

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902973407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9892 BUSTLETON AVE",
            "address_2": "SUITE 303",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191152184",
            "telephone_number": "215-673-3200",
            "fax_number": "215-673-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9892 BUSTLETON AVE",
            "address_2": "SUITE 303",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191152184",
            "telephone_number": "215-673-3200",
            "fax_number": "215-673-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTIG",
        "first_name": "AMY",
        "middle_name": "B",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC004390L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.