Individual provider Active NPI

Nicholas Charles Fasano, MD

  • Diagnostic Radiology Physician
  • Worcester, MA
National Provider Identifier
1013932292
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD428992 Issued in PA
Practice address
55 Lake Ave North
Worcester, MA 01655-0002
Phone
(508) 334-3850
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 1018905 MA
Diagnostic Radiology Physician 2085R0202X MD428992 PA Primary
Diagnostic Radiology Physician 2085R0202X D0087818 MD

Addresses

Primary practice location

55 Lake Ave North
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other practice location 1

35 Monument Rd Ste 201
York, PA 17403-5074
Phone (717) 812-4083

Other practice location 2

22 S Greene St, Dept of Radiology
Baltimore, MD 21201-1544
Phone (410) 328-3477

Other practice location 3

169 Martin Ave
Ephrata, PA 17522-1734
Phone (717) 738-6414

Other practice location 4

14781 Wolfe Rd
New Freedom, PA 17015-8011
Phone (717) 674-7600

Other practice location 5

36 Robinhood Dr
Etters, PA 17319-9528
Phone (717) 388-7300

Other practice location 6

147 Gettys St
Gettysburg, PA 17325-2534
Phone (717) 337-4207

Other practice location 7

35 Erick Rd
Lancaster, PA 17601-3111
Phone (717) 690-0785

Other practice location 8

112 N 7th St
Chambersburg, PA 17201-1720
Phone (717) 262-4499

Other practice location 9

1201 Letort Springs Way
Carlisle, PA 17015-8011
Phone (717) 674-7600

Other practice location 10

252 S 4th St
Lebanon, PA 17042-6111
Phone (717) 270-7732

Other identifiers 3

IdentifierTypeStateIssuer
072163821MedicaidDC
1017198590001MedicaidPA
887303800MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MD, DC, MA4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20060919000004 PA Practitioner - Diagnostic Radiology 9830194257 Reassigns benefits to 5 organizations
I20190806000534 MD Practitioner - Diagnostic Radiology 9830194257 Reassigns benefits to 1 organization
I20190806001196 DC Practitioner - Diagnostic Radiology 9830194257 Reassigns benefits to 1 organization
I20240912003188 MA Practitioner - Diagnostic Radiology 9830194257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Perelman School of Med at the University of Pennsylvania, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Imaging of Lehigh Valley PCGroup PAC ID 1557265212, 115 clinicians
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1200 S Cedar Crest Blvd
Allentown, PA 18103-6202
Phone (610) 770-1606

1200 S Cedar Crest Blvd 3Rd FL Kasych
LVPG Burn Surgery
Allentown, PA 18103-6202
Phone (610) 402-8355

1200 S Cedar Crest Blvd FL
1 LVPG Nephrology
Allentown, PA 18103-6202
Phone (610) 402-8510

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

2545 Schoenersville Rd
Bethlehem, PA 18017-7300

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0087818MDMDDiagnostic Radiology Physician
MD428992PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Jan 19, 2026 Accepting new patients
Umass Memorial Radiology Phys Serv Diagnostic Radiology CurrentSince Dec 1, 2024 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Feb 27, 2024 Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 1, 2025 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Wellspan Medical Group CurrentSince Jan 19, 2026 Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 1, 2025 Accepting new patients
University Imaging Center, LLC Diagnostic Radiology CurrentSince Sep 1, 2019 Accepting new patients
University Imaging Center, LLC Diagnostic Radiology CurrentSince Sep 1, 2019 Accepting new patients
Medical Imaging of Lehigh Valley PC Diagnostic Radiology CurrentSince Dec 1, 2024 Accepting new patients
Evangelical Rad Assoc LTD Diagnostic Radiology Past Accepting new patients

Locations

14 Prospect St
Milford, MA 01757
Phone (508) 422-2343

340 Thompson Rd
Webster, MA 01570
Phone (508) 943-2600

10 Little Brook Rd
West Wareham, MA 02576

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

419 W Redwood St
Baltimore, MD 21201
Phone (410) 328-5196

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

2100 Mack Blvd
Allentown, PA 18103
Phone (484) 224-1892

112 N 7th St
Chambersburg, PA 17201
Phone (717) 217-4300

169 Martin Ave
Ephrata, PA 17522
Phone (717) 733-0311

147 Gettys St
Gettysburg, PA 17325
Phone (717) 334-2121

35 Erick Rd
Lancaster, PA 17601
Phone (717) 690-0785

252 S 4th St
Lebanon, PA 17042
Phone (717) 270-7500

1 Hospital Dr
Lewisburg, PA 17837
Phone (570) 522-2000

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

35 Monument Rd
Ste 201
York, PA 17403
Phone (717) 812-3712

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1013932292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE NORTH",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Monument Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174035074",
            "country_code": "US",
            "telephone_number": "717-812-4083",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22 S GREENE ST, DEPT OF RADIOLOGY",
            "address_purpose": "LOCATION",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "country_code": "US",
            "telephone_number": "410-328-3477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "169 Martin Ave",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "PA",
            "postal_code": "175221734",
            "country_code": "US",
            "telephone_number": "717-738-6414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14781 Wolfe Rd",
            "address_purpose": "LOCATION",
            "city": "New Freedom",
            "state": "PA",
            "postal_code": "170158011",
            "country_code": "US",
            "telephone_number": "717-674-7600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36 Robinhood Dr",
            "address_purpose": "LOCATION",
            "city": "Etters",
            "state": "PA",
            "postal_code": "173199528",
            "country_code": "US",
            "telephone_number": "717-388-7300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "147 Gettys St",
            "address_purpose": "LOCATION",
            "city": "Gettysburg",
            "state": "PA",
            "postal_code": "173252534",
            "country_code": "US",
            "telephone_number": "717-337-4207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35 Erick Rd",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176013111",
            "country_code": "US",
            "telephone_number": "717-690-0785",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "112 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Chambersburg",
            "state": "PA",
            "postal_code": "172011720",
            "country_code": "US",
            "telephone_number": "717-262-4499",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 Letort Springs Way",
            "address_purpose": "LOCATION",
            "city": "Carlisle",
            "state": "PA",
            "postal_code": "170158011",
            "country_code": "US",
            "telephone_number": "717-674-7600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "252 S 4th St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170426111",
            "country_code": "US",
            "telephone_number": "717-270-7732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FASANO",
        "first_name": "NICHOLAS",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "1018905",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD428992",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0087818",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "072163821",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017198590001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "887303800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.