Active NPI
Carmina M Fusco, DPM
- Foot Surgery Podiatrist
- San Antonio, TX
National Provider Identifier
1104822683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot Surgery Podiatrist
- License
- 1812
- Practice address
- 1715 McCullough Ave
2ND Floor
San Antonio, TX 78212-4046 - Phone
- (210) 732-3668
- Fax
- (201) 732-3338
- NPI assigned
- Jun 21, 2005
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Foot Surgery Podiatrist | 213ES0131X | 1812 | TX | Primary |
Addresses
Primary practice location
1715 McCullough Ave
2ND Floor
San Antonio, TX 78212-4046
Mailing address
1715 McCullough Ave
2ND Floor
San Antonio, TX 78212-4046
Phone (210) 732-3668
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TXB154993 | Other | WELLMED NETWORKS INC | |
| 8J1317 | Other | TX | BCBS |
| 0035PT | Other | TX | BCBS |
| TXB126362 | Other | TX | WELLMED |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 246 | NM | MD | Physical Therapist |
Interoperability endpoints
- carmina.fusco@wellmed.eclinicaldirectplus.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492646400000",
"number": "1104822683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1715 MCCULLOUGH AVE",
"address_2": "2ND FLOOR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782124046",
"telephone_number": "210-732-3668",
"fax_number": "201-732-3338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1715 MCCULLOUGH AVE",
"address_2": "2ND FLOOR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782124046",
"telephone_number": "210-732-3668",
"fax_number": "201-732-3338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUSCO",
"first_name": "CARMINA",
"middle_name": "M",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-21",
"last_updated": "2017-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "TX",
"license": "1812",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMED NETWORKS INC",
"identifier": "TXB154993",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8J1317",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0035PT",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMED",
"identifier": "TXB126362",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.