DR. JACQUELINE O LUSTIG (D.O.) – Family Medicine Physician, NPI 1245246966

DR. JACQUELINE O LUSTIG (D.O.) is a healthcare provider. based in Watertown, Connecticut. specializing in Family Medicine Physician. They hold the professional credentials D.O.. They hold a License No. 041948 (CT). The NPI Number for DR. JACQUELINE O LUSTIG (D.O.) is 1245246966

Main info

Female
Sole Proprietor
33 Years Of Experience
Accepts Medicare Assignment
Name
DR. JACQUELINE O LUSTIG (D.O.)
NPI
1245246966
Phone
(860) 274-8891
Address
380 MAIN ST
Enumeration Date
1 August 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
NOVA SOUTHEASTERN COLLEGE OF OSTEO MEDICINE
Secondary Phone
8602748891
Graduation Year
1993 (33 years ago)
PAC ID
2264441971
Group Practice PAC ID
2466461173
Professional Enrollment ID
I20060407000228
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for DR. JACQUELINE O LUSTIG (D.O.)

  • 380, Main Street, Watertown, Middlesex County, Massachusetts, 02472, United States

    WATERTOWN, CT 067952260

    Phone: (860) 274-8891

    Fax: (860) 274-8895

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2006-04-07

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060407000228IFamily PracticeCTTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06795)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2466461173View full group profile

Reviews

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Frequently asked questions

How is DR. JACQUELINE O LUSTIG (D.O.) identified in CMS data?
CMS-hosted NPPES data lists DR. JACQUELINE O LUSTIG (D.O.) with NPI 1245246966.
Is DR. JACQUELINE O LUSTIG (D.O.) listed as active for patients and plans?
The listing shows DR. JACQUELINE O LUSTIG (D.O.) as active in the NPI system.
What taxonomy line describes DR. JACQUELINE O LUSTIG (D.O.)?
For research purposes, treat DR. JACQUELINE O LUSTIG (D.O.) as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for DR. JACQUELINE O LUSTIG (D.O.)?
DR. JACQUELINE O LUSTIG (D.O.)'s geographic hint is Watertown, Connecticut in our summary view.
Why does DR. JACQUELINE O LUSTIG (D.O.) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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