Individual provider Active NPI

Brett Michael Kusmit, RPA/RA

  • Radiology Practitioner Assistant
  • Phoenix, AZ
National Provider Identifier
1124391248
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Practitioner AssistantTaxonomy code 243U00000X
Practice address
16641 N. 40TH St.,
Ste 1
Phoenix, AZ 85032-3343
Phone
(623) 931-7999
Fax
(623) 842-5640
NPI assigned
Feb 21, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Practitioner Assistant 243U00000X Primary

Addresses

Primary practice location

16641 N. 40TH St.,
Ste 1
Phoenix, AZ 85032-3343

Mailing address

2323 W. Rose Garden Lane
Phoenix, AZ 85027-2530
Phone (623) 931-7999

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Imaging Services LLC Diagnostic Radiology Past Accepting new patients
Banner Imaging Services LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1124391248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 W. ROSE GARDEN LANE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850272530",
            "telephone_number": "623-931-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16641 N. 40TH ST.,",
            "address_2": "STE 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323343",
            "telephone_number": "623-931-7999",
            "fax_number": "623-842-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSMIT",
        "first_name": "BRETT",
        "middle_name": "MICHAEL",
        "credential": "RPA/RA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-21",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "243U00000X",
            "taxonomy_group": "",
            "desc": "Radiology Practitioner Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.