MICHAEL L LUSTBADER (NPI# 1518923150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518923150 |
| Entity Type | Individual |
| Full Name | MICHAEL L LUSTBADER |
| Credential | M.D. |
| Practice Address |
701 Fifth Street Beaver PA 15009 |
| Practice Telephone | 7247756500 |
| Practice Fax Number | 7247756755 |
| Mailing Telephone | 7247756500 |
| Mailing Fax Number | 7247756755 |
| Enumeration Date | 2006-04-22 |
| Last Update Date | 2011-04-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | MD031897E | PA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0949960 | 05 | |
| PA | UPMC | 251711755 | 01 |
| PA | BLUE SHEILD PA | 105466 | 01 |
| PA | RAILROAD MEDICARE | 34002813 | 01 |
| PA | HEALTH AMERICA UPIN | B36620 | 01 |
| PA | ANTHEM BC BS | 000000115067 | 01 |
| PA | 983011-0004 | 05 | |
| PA | GATEWAY INDIVIDUAL | 1008649 | 01 |
| PA | MED PLUS INDIVIDUAL | 10296 | 01 |
| OH | 0794145 | 05 | |
| PA | BWC | 251603474-00 | 01 |
| PA | HEALTH AMERICA | 251711755 | 01 |
| Street Address |
701 FIFTH STREET |
| City | BEAVER |
| State | PA |
| Zip Code | 15009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548734494 | Renee Thomas | Registered Nurse | 659 3rd Street, Upper Suite, Beaver, PA 15009 | 2019-01-14 |
| 1275048654 | Dominic J. Deluigi Phd LLC | Psychologist | 500 Market St., Sutei 204b, Beaver, PA 15009 | 2017-12-07 |
| 1861845208 | Gary Koch | Psychologist | 500 Market St Ste 204b, Beaver, PA 15009 | 2016-07-21 |
| 1326367616 | Merakey Pennsylvania | Community/Behavioral Health | 148 Theodore Drive, Chippewa, PA 15009 | 2010-05-26 |
| 1912237215 | Sandra L. Mckeel | Counselor | 697 State Street, Vanport, PA 15009 | 2010-01-08 |
| 1790019438 | Tri-state Medical Group, Inc. | Physical Medicine & Rehabilitation | 1030 Beaner Hollow Road, Beaver Medical Commons, Beaver, PA 15009 | 2009-09-29 |
| 1700040730 | Marie R Brauch | Counselor | 697 State St, #5, Beaver, PA 15009 | 2008-07-18 |
| 1932376696 | Justin Dosch | Emergency Medicine | 1000 Dutch Run Rd, Beaver, PA 15009 | 2008-05-13 |
| 1023280492 | Paul Michael Kuzma Jr Md | Ophthalmology | 628 Market Street, Bridgewater, PA 15009 | 2008-03-26 |
| 1881877868 | Jaime Michelle Kinkead | Social Worker | 160 Third Street, Beaver, PA 15009 | 2007-12-12 |
| Find all providers in zip 15009 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447264346 | Nicholas Nmn Tapyrik | Specialist | 1425 3rd St, Beaver, PA 15009-2427 | 2006-07-28 |
| 1144248543 | Paul Michael Kuzma Jr. | Specialist | 628 Market St, Beaver, PA 15009-2923 | 2006-07-17 |
| 1588697338 | Alejandro R. Gonzalez | Specialist | 1 Peartree Way, Beaver, PA 15009-1954 | 2006-07-07 |
| 1235170192 | Mousa I Dababnah | Specialist | 856 Ritter Dr, Beaver, WV 25813-9513 | 2006-06-09 |
| 1346208584 | Peter Eugene Volpe | Specialist | 1417 3rd St, Beaver, PA 15009-2427 | 2006-05-03 |
| 1750348637 | Paul M Hoover | Specialist | 647 Third Street, Beaver, PA 15009 | 2006-04-26 |
| 1073503637 | Prime Health Associates | Specialist | 703 Ritter Drive, Beaver, WV 25813 | 2005-10-25 |
| 1215372933 | Heritage Valley Medical Group, Inc | Specialist | 1000 Dutch Ridge Rd, Beaver, PA 15009-9727 | 2013-05-08 |
| 1053615120 | Valley Sleep Solutions | Specialist | 5060 Tuscarawas Rd, Beaver, PA 15009-1006 | 2011-01-05 |
| 1164561932 | Nicholas Tapyrik, M.d., Ltd. | Specialist | 1425 3rd St, Beaver, PA 15009-2427 | 2007-02-06 |
| Find all providers in BEAVER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.