| Dr Justin Jeremiah Lightburn, MD | |
|
1855 S Main St, Goshen, IN 46526-4852 | |
| (574) 533-7476 | |
| (574) 533-7145 |
| Full Name | Dr Justin Jeremiah Lightburn |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 17 Years |
| Location | 1855 S Main St, Goshen, Indiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346401395 | NPI | - | NPPES |
| 201107430 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 01073831A (Indiana) | Secondary |
| 2085R0204X | Radiology - Vascular & Interventional Radiology | 01073831A (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Goshen Hospital | Goshen, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Goshen Health System Inc | 4880598572 | 140 |
| Entity Name | Northern Indiana Magnetic Resonance Center, Llp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447252200 PECOS PAC ID: 6709780802 Enrollment ID: O20031120000842 |
| Entity Name | Goshen Health System Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194772293 PECOS PAC ID: 4880598572 Enrollment ID: O20031124000658 |
| Entity Name | Radiology Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578557815 PECOS PAC ID: 5890695464 Enrollment ID: O20040515000242 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Justin Jeremiah Lightburn, MD Po Box 834, Goshen, IN 46527-0834 Ph: () - | Dr Justin Jeremiah Lightburn, MD 1855 S Main St, Goshen, IN 46526-4852 Ph: (574) 533-7476 |
Lakshmi Gullapalli, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 200 High Park Ave, Goshen, IN 46526 Phone: 574-533-2141 | |
Dr. Houman Vaghefi, MD, PHD Radiology Medicare: Accepting Medicare Assignments Practice Location: 200 High Park Ave, Goshen, IN 46526 Phone: 574-364-2888 Fax: 574-364-2480 | |
Dr. Charles W Bower, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1855 S Main St Ste A, Goshen, IN 46526 Phone: 574-533-7476 | |
Helen Winer-muram, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 200 High Park Ave, Goshen, IN 46526 Phone: 574-533-2141 | |
James A Wheeler, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 200 High Park Ave, Goshen, IN 46526 Phone: 574-533-2141 | |
Mrs. Irina Vita Sparks, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 200 High Park Ave, Goshen, IN 46526 Phone: 574-364-2888 |