ALEXANDER MICHAEL LUSTBERG (M.D.) – Gastroenterology Physician, NPI 1225009301
Gastroenterology Physician
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Profile Insights
NPPES metrics only — not quality of care.
21,511 INTERNAL MEDICINE in CA
Provider Addresses for ALEXANDER MICHAEL LUSTBERG (M.D.)
34 Mark West Springs Rd Fl 2
Santa Rosa, CA 954031766
Phone: (707) 541-7900
Fax: (707) 573-5411
Type: Location
500, Doyle Park Drive, Santa Rosa, Sonoma County, California, 95405, United States
SANTA ROSA, CA 954054558
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $1,505.
Total Amount is formed as General ($1,505) + Research ($0) + Ownership ($0) = $1,505.
Last reported payment date: 2024-11-19 • Largest payer in this snapshot: Boston Scientific Corporation ($1,449).
Total Amount
$1,505
General + Research + Ownership
Payments
11
Total payment records
General Amount
$1,505
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $1,449 |
| Janssen Biotech, Inc. | $56 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-08-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040823000661 | I | Gastroenterology | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 147 | 118 | $0 |
| 45380 | Biopsy of large bowel using a flexible endoscope | 140 | 140 | $0 |
| 45385 | Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 134 | 133 | $0 |
| 43239 | Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 128 | 127 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 59 | 54 | $0 |
Insurance plans in this area (ZIP 95403)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | CA | |
| A L L E R G Y/ I M M U N O L O G Y | CA | |
| - | CA | |
| Hospitalist, Obstetrics/Gynecology | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OR | |
| - | CA | |
| - | CA | |
| - | CA | |
| - | CA | |
| A N E S T H E S I O L O G Y | CA |
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