Individual provider Active NPI

Kristelle Lusby

  • Surgery Physician
  • Orange, CA
National Provider Identifier
1932336278
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A107784 Issued in CA
Practice address
333 City Blvd W
#705
Orange, CA 92868-2903
Phone
(714) 456-5532
NPI assigned
Jun 13, 2009
Last updated
Mar 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A107784 CA Primary

Addresses

Primary practice location

333 City Blvd W
#705
Orange, CA 92868-2903

Mailing address

6399 San Ignacio Ave Ste 120
San Jose, CA 95119-1215
Phone (408) 369-5620

Other practice location 1

603 S Knickerbocker Dr
Sunnyvale, CA 94087-1034
Phone (408) 736-0441

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
I20170728001803 CA Practitioner - Plastic and Reconstructive Surgery 2860619590 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Eastern Virginia Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3425 S Bascom Ave
Suite 100
Campbell, CA 95008-7300
Phone (408) 396-1115

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.34 of 100Reported as group
Quality
90.85
Promoting interoperability
87
Improvement activities
40
Cost
71.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision36
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A107784CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kristelle Lusby MD CurrentSince Jul 23, 2023 Accepting new patients
Csi Medical Group CurrentSince Jul 1, 2017 Accepting new patients
El Camino Hospital Past Accepting new patients
Carlsbad and Vista Dermatology, Inc. PastSince Jul 1, 2017 Accepting new patients
California Skin Institute, a Medical Corporation Past Accepting new patients
El Camino Health Medical Network, LLC Past Accepting new patients
Good Samaritan Hospital Ca LTD PTP Past Accepting new patients
UCSF Health Community Hospitals Past Accepting new patients
St. Mary's Good Samaritan Hospital, Inc. Past Accepting new patients
St Francis Medical Center Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients
Eden Medical Center/San Leandro Hospital Campus Past Accepting new patients
Bernard Recht, PH.D., M.D., Inc. Past Accepting new patients

Locations

501 S Shore Ctr W
Ste 103A
Alameda, CA 94501
Phone (510) 227-7028

3425 S Bascom Ave
Ste 100
Campbell, CA 95008
Phone (408) 371-1118

1524 McHenry Ave
Ste 470
Modesto, CA 95350
Phone (209) 525-8292

9781 Blue Larkspur Ln
Ste 100
Monterey, CA 93940
Phone (831) 333-9008

525 South Dr
Ste 115
Mountain View, CA 94040
Phone (408) 369-5600

909 Hyde St
Ste 419
San Francisco, CA 94109
Phone (415) 678-5887

2420 Samaritan Dr
San Jose, CA 95124
Phone (408) 369-5600

6399 San Ignacio Ave
Ste 120
San Jose, CA 95119
Phone (408) 369-5620

136 N San Mateo Dr
San Mateo, CA 94401
Phone (650) 348-1242

3562 Round Barn Cir
Ste 320
Santa Rosa, CA 95403
Phone (707) 578-1900

18988 Cox Ave
Ste B
Saratoga, CA 95070
Phone (408) 253-4407

603 S Knickerbocker Dr
Sunnyvale, CA 94087
Phone (408) 736-0441

4201 Torrance Blvd
Ste 640
Torrance, CA 90503
Phone (310) 375-9994

1934 Via Ctr
Ste B
Vista, CA 92081
Phone (760) 295-2299

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: klusby@csinorthca.emadirect.md
  • Direct secure messaging: klusby43199@icare.elcaminohospital.org

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1244851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1932336278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6399 SAN IGNACIO AVE STE 120",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191215",
            "telephone_number": "408-369-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CITY BLVD W",
            "address_2": "#705",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682903",
            "telephone_number": "714-456-5532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "603 S Knickerbocker Dr",
            "address_purpose": "LOCATION",
            "city": "Sunnyvale",
            "state": "CA",
            "postal_code": "940871034",
            "country_code": "US",
            "telephone_number": "408-736-0441",
            "fax_number": "408-736-0722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUSBY",
        "first_name": "KRISTELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-13",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A107784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.