Active NPI
James C Fuselier, DDS MD
- Oral and Maxillofacial Surgery (Dentist)
- Austin, TX
National Provider Identifier
1174595664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 17190
- Practice address
- 2501 W William Cannon Dr
Suite 6B
Austin, TX 78745-5281 - Phone
- (512) 447-6684
- NPI assigned
- Feb 7, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 17190 | TX | Primary |
Addresses
Primary practice location
2501 W William Cannon Dr
Suite 6B
Austin, TX 78745-5281
Mailing address
711 W 38TH St
Suite a-1
Austin, TX 78705-1121
Phone (512) 454-1220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| K2964 | Other | TX | MEDICAL LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 23, 2024 through Jan 23, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17190 | TX | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409788800000",
"number": "1174595664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 W 38TH ST",
"address_2": "SUITE A-1",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787051121",
"telephone_number": "512-454-1220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 W WILLIAM CANNON DR",
"address_2": "SUITE 6B",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787455281",
"telephone_number": "512-447-6684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUSELIER",
"first_name": "JAMES",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DDS MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-07",
"last_updated": "2014-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "TX",
"license": "17190",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE NUMBER",
"identifier": "K2964",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.