KELLIE J LUSTENBERGER (N.P.) – Family Nurse Practitioner, NPI 1295923779
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for KELLIE J LUSTENBERGER (N.P.)
305 W. JACKSON, SUITE 100
NEW HORIZONS OBSTETRICS & GYNECOLOGY
CARBONDALE, IL 62901
Phone: (618) 457-0404
Fax: (618) 457-0440
Type: Location
100, West Jackson Street, Carbondale, Jackson County, Illinois, 62901, United States
CARBONDALE, IL 629011474
Phone: (618) 457-0404
Fax: (618) 457-0440
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 10 Open Payments records for all available years, with a total value of $135.
Total Amount is formed as General ($135) + Research ($0) + Ownership ($0) = $135.
Last reported payment date: 2024-09-12 • Largest payer in this snapshot: MAYNE PHARMA COMMERCIAL LLC ($135).
Total Amount
$135
General + Research + Ownership
Payments
10
Total payment records
General Amount
$135
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| MAYNE PHARMA COMMERCIAL LLC | $135 |
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: 2008-04-12
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 |
|---|---|---|---|---|
| I20080412000078 | I | Nurse Practitioner | IL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62901)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| - | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL |
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