Heather Lynn Lustig, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

4704224096 Issued in MI

Practice address

32255 Northwestern Hwy Ste 214
Farmington Hills, MI 48334-1573

Phone

(248) 855-5620

NPI assigned

Jul 13, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Heather Lynn Decovich Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Beaumont Medical Group Hospital -Based Services

  • Hospitalist Physician
  • Royal Oak, MI
  • NPI 1427567858
  Medicare reassignment NPD
• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment NPD
• Dr. Susan Seman PLC

  • Surgery Physician
  • West Bloomfield, MI
  • NPI 1134152150
  NPD (past)

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1942439815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 ORCHARD LAKE RD STE 204",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223425",
            "telephone_number": "248-855-4177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32255 NORTHWESTERN HWY STE 214",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483341573",
            "telephone_number": "248-855-5620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6900 Orchard Lake Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483223425",
            "country_code": "US",
            "telephone_number": "248-855-4177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3601 W 13 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736712",
            "country_code": "US",
            "telephone_number": "248-898-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUSTIG",
        "first_name": "HEATHER",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-13",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704224096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hlustig9834@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3601 W 13 Mile Rd",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "DECOVICH",
            "middle_name": "LYNN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Yasmine Lusby
• Jeffery Joseph Lusko, MA, LLP
• Ethan Lussier
• Bijon Luster
• Denice Lustig
• Julie Lutao
• Jennifer Luther
• Kristie Luther
• Michelle Luther
• Zachary Luther

• Gerontology Nurse Practitioner in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Gerontology Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.