Nika Lustgarten, DDS is a medicare enrolled "Student In An Organized Health Care Education/training Program" provider in Portland, Oregon. Her current practice location is
3181 Sw Sam Jackson Park Rd, Portland, Oregon. You can reach out to her office (for appointments etc.) via phone at
(503) 494-8211.
Nika Lustgarten is licensed to practice in Oregon (license number D11224) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1487005187.
Healthcare Provider's Profile
Full Name | Nika Lustgarten |
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Gender | Female |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 3181 Sw Sam Jackson Park Rd, Portland, Oregon |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1487005187
- Provider Enumeration Date: 06/24/2016
- Last Update Date: 05/17/2023
Medicare PECOS Information:
- PECOS PAC ID: 0244524189
- Enrollment ID: I20181016001211
Medical Identifiers
Medical identifiers for Nika Lustgarten such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1487005187 | NPI | - | NPPES |
0076372 | Medicaid | IA | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | 1001515-15 (Wisconsin) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | D11224 (Oregon) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nika Lustgarten is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Nika Lustgarten, DDS 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 Ph: (503) 494-8211 | Nika Lustgarten, DDS 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 Ph: (503) 494-8211 |
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