Dominic Anthony Cusumano IV, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501018404 Issued in MI

Practice address

48875 Hayes Rd
Shelby TWP, MI 48315-4405

Phone

(586) 532-9602

Fax

(586) 439-5380

NPI assigned

Sep 6, 2017

Sex

Male

Sole proprietor

No

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.

• KSS of Shelby LLC

  • Physical Therapy Clinic/Center
  • Shelby Township, MI
  • NPI 1770788739

  MI, Physical Therapist

  Medicare reassignment Care Compare group NPD
• KSS of Shelby LLC

  • Durable Medical Equipment & Medical Supplies
  • Shelby TWP, MI
  • NPI 1902769029
  Care Compare group NPD

Specialty

Physical Therapist in Private Practice

Education

University of Michigan Medical School, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

KSS of Shelby LLC 23 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

70.77 of 100Reported as group

Quality

66.1

Improvement activities

40

Cost

64.7

Medicare fee-for-service enrollment

Enrolled in MI

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 6, 2017.

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504656000000",
    "number": "1033637459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1773 STAR BATT DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093708",
            "telephone_number": "248-601-9207",
            "fax_number": "248-650-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48875 HAYES RD",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483154405",
            "telephone_number": "586-532-9602",
            "fax_number": "586-439-5380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSUMANO",
        "first_name": "DOMINIC",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-06",
        "last_updated": "2017-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan E Craig, DC
• Shara L Croff, MD
• Natalie Danielle Crossen
• Dylan Cruz, MEDICAL STUDENT
• Jonnie Rae Cude
• Leigh M Czerwinski, M.A., CCC-SLP
• Danielle Nicole Dababneh, FNP
• Lindsay Nicole Dalach, CTRS
• Candace Lynne Daniels, LMSW.
• Kelly Marie Danielson, M.S.W.

• All providers in Shelby TWP, MI
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.