Individual provider Active NPI

Eric Michael Fiscus, MOT, OTR

  • Physical Rehabilitation Occupational Therapist
  • Kokomo, IN
National Provider Identifier
1033630694
Registry record updated Aug 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
31005618A Issued in IN
Practice address
2233 W Jefferson St
Kokomo, IN 46901-4121
Phone
(765) 457-9175
NPI assigned
Jul 4, 2017
Last updated
Aug 24, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X 31005618A IN Primary

Addresses

Primary practice location

2233 W Jefferson St
Kokomo, IN 46901-4121

Mailing address

4058 S 580 W
Russiaville, IN 46979-9796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190412001718 IN Practitioner - Occupational Therapist in Private Practice 2264773589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

343 E 90TH Dr
Merrillville, IN 46410-8152
Phone (219) 207-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC CurrentSince Oct 19, 2018 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC CurrentSince Oct 19, 2018 Accepting new patients

Locations

2500 W Kilgore Ave
Muncie, IN 47304
Phone (765) 201-7878

536 Old Howell Rd
Greenville, SC 29615
Phone (877) 508-3237

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1499126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503532800000",
    "number": "1033630694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4058 S 580 W",
            "city": "RUSSIAVILLE",
            "state": "IN",
            "postal_code": "469799796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 W JEFFERSON ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469014121",
            "telephone_number": "765-457-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCUS",
        "first_name": "ERIC",
        "middle_name": "MICHAEL",
        "credential": "MOT, OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-04",
        "last_updated": "2017-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "IN",
            "license": "31005618A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.