DR. JACOB J LUSTGARTEN (NPI# 1316072598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316072598 |
| Entity Type | Individual |
| Full Name | DR. JACOB J LUSTGARTEN |
| Credential | M.D. |
| Practice Address |
10810 Connecticut Avenue Kensington MD 20895 |
| Mailing Address |
2101 East Jefferson Street Kaiser Permanente, Ppqa, 6 West, Attn: Theresa Brooks Rockville MD 20852 |
| Practice Telephone | 3019297100 |
| Practice Fax Number | 3019297114 |
| Mailing Telephone | 3018166660 |
| Mailing Fax Number | 3018166308 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
0101229914 | VA | Allopathic & Osteopathic Physicians |
| X | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MD32668 | DC | Allopathic & Osteopathic Physicians |
| X | 2086S0129X |
Surgery Specialization: Vascular Surgery |
D56700 | MD | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467869982 | Jacob Lustgarten | Physician Assistant | 1500 Cooper St, Fort Worth, TX 76104-2710 | 2014-07-16 |
| Street Address |
10810 CONNECTICUT AVENUE |
| City | KENSINGTON |
| State | MD |
| Zip Code | 20895 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437236023 | Carolyn L Avery | Pediatrics | 10810 Connecticut Avenue, Kensington, MD 20895-2138 | 2006-11-01 |
| 1083743173 | Ilan Irony | Internal Medicine | 10810 Connecticut Avenue, Kensington, MD 20895 | 2007-03-05 |
| 1316076417 | Elizabeth Victoria Molyneaux | Anesthesiology | 10810 Connecticut Avenue, Kensington, MD 20895 | 2007-03-05 |
| 1437288537 | John Clark Lucas | Family Medicine | 10810 Connecticut Avenue, Kensington, MD 20895 | 2007-03-05 |
| 1215064746 | Susan Duncan Calkins | Chiropractor | 10810 Connecticut Avenue, Kensington, MD 20895 | 2007-02-28 |
| 1043347149 | Caesar Augustus Junker | Family Medicine | 10810 Connecticut Avenue, Kensington, MD 20895 | 2007-02-27 |
| 1770623126 | Rohit K Bhatnagar | Ophthalmology | 10810 Connecticut Avenue, Kensington, MD 20895 | 2007-02-07 |
| 1982741591 | Katherine Langerfelder Whitaker | Anesthesiology | 10810 Connecticut Avenue, Kensington, MD 20895 | 2007-01-31 |
| 1174660781 | Kawaljeet K Chawla | Pediatrics | 10810 Connecticut Avenue, Kensington, MD 20895 | 2007-01-31 |
| 1275679565 | John S Hashim | Radiology | 10810 Connecticut Avenue, Kensington, MD 20895 | 2007-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760015457 | Express Yourself Therapy | Occupational Therapist | 3930 Kowles Ave Suite 306, Kensington, MD 20895 | 2020-02-20 |
| 1891343992 | Christine Brandt | Nurse Practitioner | 10605 Concord St Ste 300, Kensington, MD 20895 | 2019-09-01 |
| 1194291765 | Kevin Charles Lorello | Physical Therapy Assistant | Kensington Park, 3620 Littledale Rd, Kensington, MD 20895 | 2018-10-22 |
| 1689154981 | Ryan Rehabilitation LLC | Counselor | 3821 Farragut Ave, Kensington, MD 20895 | 2018-08-16 |
| 1659865673 | Edward Li | Pharmacist | 5110 Nicholson Lane, Kensington, MD 20895 | 2018-06-22 |
| 1245735919 | Kyeshia White | Behavior Technician | 5268-g Nicholson Lane #188, Kensington, MA 20895 | 2018-03-26 |
| 1073036778 | Andrea Zawatsky | Social Worker | 20895 Concord St, 207, Kensington, MD 20895 | 2017-07-25 |
| 1871981860 | Rebecca Abramson | Counselor | 3702 Perry Ave, Kensington, MD 20895 | 2014-12-30 |
| 1730505744 | Claire Lerner | Social Worker | 3841 Farragut Avenue, Abrams and Associates, Kensington, MD 20895 | 2014-03-14 |
| 1588002224 | Yitbarek Abebe | Pharmacist | 3200 Red Orchid Way, Kensington, MD 20895 | 2013-06-04 |
| Find all providers in zip 20895 | ||||
| Taxonomy Code | 2086S0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Critical Care |
| A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275789430 | Khanjan H Nagarsheth | Surgery | 419 W Redwood St Ste 240, Baltimore, MD 21201-7004 | 2008-08-07 |
| 1255597100 | John Robert Klune | Surgery | 22 South Greene St, Shock Trauma Center, Baltimore, MD 21401 | 2008-07-31 |
| 1952564395 | Jason Anthony Brocker | Surgery | 4940 Eastern Ave Bldg 5th, Baltimore, MD 21224-2735 | 2008-07-07 |
| 1508989807 | Ahmed M Ali | Surgery | 12307 Pleasant Prospect Rd, Bowie, MD 20721-2516 | 2007-04-09 |
| 1659370039 | Michelle Denise Thomas | Surgery | 12172 Central Ave, #100, Mitchellville, MD 20721-1900 | 2005-07-19 |
| 1700415635 | University of Maryland St Joseph Foundation Inc | Surgery | 7601 Osler Dr, Towson, MD 21204-7700 | 2020-04-03 |
| 1235649526 | Johns Hopkins University | Surgery | 1800 Orleans St, Baltimore, MD 21287-0010 | 2017-10-02 |
| 1730509837 | Robert Anthony Laskowski II | Surgery | 22 S Greene St # T1r53, Baltimore, MD 21201-1544 | 2014-04-16 |
| 1164846077 | Rachel Leah Choron | Surgery | 600 N Wolfe Street, Zayed Suite 6107, Baltimore, MD 21287-0005 | 2014-02-12 |
| 1770926131 | Katherine Marie Kelley | Surgery | 22 S Greene St, Baltimore, MD 21201 | 2013-04-16 |
| Find all providers with the same taxonomy | ||||
| City | KENSINGTON |
| Zip Code | 20895 |
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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.