Individual provider Active NPI

Nicholas Fusco

  • Emergency Medicine Physician
  • Kissimmee, FL
National Provider Identifier
1053852483
Registry record updated Sep 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS16580 Issued in FL
Practice address
700 W Oak St
Kissimmee, FL 34741-4924
Phone
(407) 399-3065
NPI assigned
Mar 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X OS16580 FL Primary

Addresses

Primary practice location

700 W Oak St
Kissimmee, FL 34741-4924

Mailing address

13038 Lessing Ave
Orlando, FL 32827-7570
Phone (407) 399-3065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200714002554 FL Practitioner - Emergency Medicine 8729401427 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

700 W Oak St
Kissimmee, FL 34741
Phone (407) 518-3553

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

6700 Lake Nona Blvd
Orlando, FL 32827
Phone (689) 216-8000

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

5731 Bee Ridge Rd
Sarasota, FL 34233
Phone (888) 221-2216

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1489795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599868800000",
    "number": "1053852483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13038 LESSING AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277570",
            "telephone_number": "407-399-3065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414924",
            "telephone_number": "407-399-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSCO",
        "first_name": "NICHOLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-18",
        "last_updated": "2020-09-12",
        "certification_date": "2020-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS16580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.