Organization Active NPI

Northwell Diagnostic Group LLC

  • Neurology Physician
  • West Palm Beach, FL
National Provider Identifier
1144946534
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
NORTHWELL DIAGNOSTIC GROUP LLC
Practice address
801 Northpoint Pkwy Ste P4
West Palm Beach, FL 33407-1973
Phone
(212) 288-2823
Fax
(212) 208-4648
NPI assigned
Oct 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Authorized official

Name
Dr. Gerard Fusaro, DCNPI 1750592853
Title
Owner
Phone
(212) 288-2823

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

801 Northpoint Pkwy Ste P4
West Palm Beach, FL 33407-1973

Mailing address

801 Northpoint Pkwy Ste 313
West Palm Beach, FL 33407-1973
Phone (212) 288-2823

National Provider Directory

National Provider Directory

Locations

801 Northpoint Pkwy
Ste 313
West Palm Beach, FL 33407

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1144946534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 NORTHPOINT PKWY STE 313",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334071973",
            "telephone_number": "212-288-2823",
            "fax_number": "212-208-4648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 NORTHPOINT PKWY STE P4",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334071973",
            "telephone_number": "212-288-2823",
            "fax_number": "212-208-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWELL DIAGNOSTIC GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-17",
        "last_updated": "2023-01-30",
        "certification_date": "2022-11-28",
        "status": "A",
        "authorized_official_last_name": "FUSARO",
        "authorized_official_first_name": "GERARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-288-2823",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.