DR. JUSTIN JEREMIAH LIGHTBURN (M.D.) – Vascular & Interventional Radiology Physician, NPI 1346401395
Vascular & Interventional Radiology Physician
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Profile Insights
NPPES metrics only — not quality of care.
847 DIAGNOSTIC RADIOLOGY in IN
Provider Addresses for DR. JUSTIN JEREMIAH LIGHTBURN (M.D.)
PO BOX 834
GOSHEN, IN 465270834
Phone:
Type: Mailing
13167 FOUNTAIN CT
GRANGER, IN 465304743
Phone: (317) 518-3293
Type: Mailing
200 HIGH PARK AVE
GOSHEN, IN 465264810
Phone: (574) 364-2808
Type: Location
620, West Edison Road, Mishawaka, Saint Joseph County, Indiana, 46545, United States
STE 110
MISHAWAKA, IN 465452784
Phone: (574) 258-1100
Fax: (574) 258-1101
Type: Mailing
1855 S MAIN ST
GOSHEN, IN 465264852
Phone: (574) 533-7476
Fax: (574) 533-7145
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 48 Open Payments records for all available years, with a total value of $3,861.
Total Amount is formed as General ($3,861) + Research ($0) + Ownership ($0) = $3,861.
Last reported payment date: 2024-12-08 • Largest payer in this snapshot: Penumbra, Inc. ($2,522).
Total Amount
$3,861
General + Research + Ownership
Payments
48
Total payment records
General Amount
$3,861
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Penumbra, Inc. | $2,522 |
| Boston Scientific Corporation | $424 |
| AngioDynamics, Inc. | $224 |
| Endologix LLC | $209 |
| Medtronic, Inc. | $105 |
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: 2014-05-13
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 |
|---|---|---|---|---|
| I20140513000293 | I | Diagnostic Radiology | IN | 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 |
|---|---|---|---|---|
| 99152 | Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes | 82 | 73 | $0 |
| 76937 | Ultrasonic guidance for blood vessel access | 31 | 27 | $0 |
| 77002 | Fluoroscopic guidance for needle placement | 31 | 30 | $0 |
| 76942 | Ultrasonic guidance for needle placement | 30 | 29 | $0 |
| 78452 | Nuclear medicine studies of heart muscle at rest and with stress and spect | 29 | 29 | $0 |
Insurance plans in this area (ZIP 46527)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | IN | 74177 | CT scan of abdomen and pelvis with contrast | 72 | 70 |
| DIAGNOSTIC RADIOLOGY | IN | 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 37 | 37 |
| DIAGNOSTIC RADIOLOGY | IN | 77012 | Radiological supervision and interpretation of CT guidance for needle insertion | 54 | 53 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN | |
| Diagnostic Radiology | IN | |
| Diagnostic Radiology | MN | |
| Diagnostic Radiology | IN | |
| Diagnostic Radiology, Interventional Radiology, Nuclear Medicine | IN | |
| Diagnostic Radiology | IN | |
| Diagnostic Radiology | IN | |
| Diagnostic Radiology | IN | |
| - | IN | |
| Diagnostic Radiology | IL |
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