NPIMap

Individual provider Active NPI

Joseph V Cusumano, MD

  • Diagnostic Radiology Physician
  • Saint Louis, MO
National Provider Identifier
1194733634
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
R9583 Issued in MO
Practice address
3915 Watson Rd
Ste. LL2
Saint Louis, MO 63109-1251
Phone
(314) 781-9711
Fax
(314) 781-9768
NPI assigned
Aug 3, 2006
Last updated
Jun 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X R9583 MO
Diagnostic Radiology Physician 2085R0202X R9583 MO Primary

Addresses

Primary practice location

3915 Watson Rd
Ste. LL2
Saint Louis, MO 63109-1251

Mailing address

750 S Hanley Rd
Apt. 52
Saint Louis, MO 63105-2670
Phone (314) 781-9711

Other identifiers 1

IdentifierTypeStateIssuer
201846201MedicaidMO

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
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Diagnostic Imaging PA Diagnostic Radiology Past Accepting new patients
JSM Enterprises, LLC Past Accepting new patients
Pearl Imaging, LLC Past Accepting new patients
Watson Imaging Center Diagnostic Radiology Past Accepting new patients
Modimoon Enterprises, LLC PastSince Apr 30, 2003 Accepting new patients
Central Radiology Group LTD Diagnostic Radiology Past Accepting new patients
Open Imaging Partners Diagnostic Radiology Past Accepting new patients

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1194733634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 S HANLEY RD",
            "address_2": "APT. 52",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631052670",
            "telephone_number": "314-781-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 WATSON RD",
            "address_2": "STE. LL2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631091251",
            "telephone_number": "314-781-9711",
            "fax_number": "314-781-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSUMANO",
        "first_name": "JOSEPH",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "MO",
            "license": "R9583",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "R9583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201846201",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.