Active NPI
Sal J Fusaro, M.D.
- Specialist
- Miami, FL
National Provider Identifier
1063425544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- ME36663
- Practice address
- 4030 Poinciana Ave
Miami, FL 33133-6329 - Phone
- (305) 442-4022
- Fax
- (305) 442-4023
- NPI assigned
- Aug 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | ME36663 | FL | Primary |
Addresses
Primary practice location
4030 Poinciana Ave
Miami, FL 33133-6329
Mailing address
4030 Poinciana Ave
Miami, FL 33133-6329
Phone (305) 442-4022
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160429000406 | FL | Order and Referring Only - Psychiatry | 1052610862 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME36663 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063425544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4030 POINCIANA AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331336329",
"telephone_number": "305-442-4022",
"fax_number": "305-442-4023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4030 POINCIANA AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331336329",
"telephone_number": "305-442-4022",
"fax_number": "305-442-4023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUSARO",
"first_name": "SAL",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "ME36663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.