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JEFFERSON LUSTRE
NPI 1760293062
Student in an Organized Health Care Education/Training Program in Baltimore, MD

Active since January 15, 2025PECOS Enrolled
9101 FRANKLIN SQUARE DR STE 300, BALTIMORE, MD 21237(443) 777-6545 Get Directions Write a Review

NPPES record last updated: June 17, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Jefferson Lustre NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEFFERSON LUSTRE (NPI 1760293062) is an individual student in an organized health care education/training program in Baltimore, Maryland and active in the NPI registry since January 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1760293062
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJEFFERSON LUSTRE
Location Address9101 FRANKLIN SQUARE DR STE 300Baltimore, MD 21237-3966
Mailing Address127 W Goodheart AveLake Mary, FL 32746-2705
Phone(443) 777-6545
Sole ProprietorYes
Enumeration DateJanuary 15, 2025
Last NPPES UpdateJune 17, 2026
NPPES CertifiedJune 17, 2026
✔ NPI 1760293062 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
9101 FRANKLIN SQUARE DR STE 300, Baltimore, MD 21237
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jefferson Lustre is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ABIGAIL R MECKES PA-C
Physician Assistant (Medical)
9101 FRANKLIN SQUARE DR STE 300
BALTIMORE, MD 21237
Baltimore County (443) 777-2000
DR. JOSEPH BLISS BRODINE M.D.
Family Medicine
9101 FRANKLIN SQUARE DR STE 300
BALTIMORE, MD 21237
Baltimore County (443) 777-2000
DR. LAUREN CATHERINE HAGGERTY PHARMD
Pharmacist
9101 FRANKLIN SQUARE DR STE 300
ROSEDALE, MD 21237
Baltimore County (443) 777-2000
LAUREN ELIZABETH DRAKE M.D.
Family Medicine
9101 FRANKLIN SQUARE DR STE 300
BALTIMORE, MD 21237
Baltimore County (443) 777-2000
DR. JULIE TAYLOR SCHULTZ M.D.
Family Medicine
9101 FRANKLIN SQUARE DR STE 300
ROSEDALE, MD 21237
Baltimore County (866) 857-9388
RUTH WATSON MD
Student in an Organized Health Care Education/Training Program
9101 FRANKLIN SQUARE DR STE 300
ROSEDALE, MD 21237
Baltimore County (443) 777-2000
WAI MAN SIN FNP-BC
Nurse Practitioner (Family)
9101 FRANKLIN SQUARE DR STE 300
BALTIMORE, MD 21237
Baltimore County (443) 777-2000
MRS. KATHERINE STOLARZ D.O.
Family Medicine
9101 FRANKLIN SQUARE DR STE 300
BALTIMORE, MD 21237
Baltimore County (443) 777-2000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jefferson Lustre's NPI number?

The NPI number for Jefferson Lustre is 1760293062. It was assigned to this individual provider in the NPPES registry on January 15, 2025.

Where is Jefferson Lustre located?

Jefferson Lustre practices at 9101 Franklin Square Dr Ste 300, Baltimore, MD 21237. The listed phone number is (443) 777-6545.

What is Jefferson Lustre's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jefferson Lustre enrolled in Medicare?

Yes. Jefferson Lustre is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jefferson Lustre was last updated on June 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.