Fanny Sarah Alie-Cusson, MD
Individual provider Active NPI Vascular Surgery Physician · Shelby, NC
NPI 1225524978 · NPPES record last updated Jul 15, 2024
Key facts
- NPI
- 1225524978
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Vascular Surgery Physician 2086S0129X
- License
- 2023-02260 (NC)
- Practice address
- 111 W Grover St
Shelby, NC 28150-3824 - Phone
- (980) 487-1900
- NPI assigned
- Jul 5, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Vascular Surgery
- Education
- Universite de Montreal, Faculte de Medecine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Carolinas Physicians Network Inc
Health Services of Central Georgia
Practice addresses (Care Compare)
111 W Grover St
Shelby, NC 28150-3824
Phone (980) 487-1900
575 1St St
Macon, GA 31201-2825
Phone (478) 743-9762
Hospital & facility affiliations
- Atrium Health Cleveland
- Carolinas Medical Center/Behav Health
- Atrium Health Navicent the Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 94 of 100
- Quality
- 81.63
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.94 of 100
- Quality
- 61.89
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.58
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Leg revascularization (restoring blood flow) | 24 |
| Removal of tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NC, GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240110003229 | NC | Practitioner - Vascular Surgery |
7315363017 | Reassigns benefits to 1 organization |
| I20250723004315 | GA | Practitioner - Vascular Surgery | 7315363017 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolinas Physicians Network Inc | Current |
Accepting new patients | |
| Health Services of Central Georgia, Inc | Surgery | Current |
Accepting new patients |
| Carolinas Physicians Network Inc | Current |
Accepting new patients | |
| University of Pittsburgh Physicians | Current | Accepting new patients | |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Carolinas Physicians Network, Inc | Past | Accepting new patients | |
| Macon Cardiovascular Institute | Surgery | Past |
Accepting new patients |
Locations
777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600
575 1st St
Macon, GA 31201
Phone (478) 742-7566
1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706
100 N 6th St
Ste 900A
Minneapolis, MN 55403
10650 Park Rd
Charlotte, NC 28210
Phone (704) 667-0337
100 Medical Park Dr
Ste 210
Concord, NC 28025
Phone (704) 403-6100
990 Lee Ann Dr NE
Concord, NC 28025
Phone (704) 441-0272
447 McAlister Rd
Ste 3200
Lincolnton, NC 28092
Phone (980) 212-6300
1550 Faulk St
Ste 3100
Monroe, NC 28112
Phone (704) 667-3410
134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100
111 W Grover St
Shelby, NC 28150
Phone (704) 482-1006
200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553
200 Lothrop St
#E3511
Pittsburgh, PA 15213
300 Halket St
Ste 5200
Pittsburgh, PA 15213
Phone (412) 641-7850
Interoperability endpoints
- faliecusson2783127@carolinashealthcaresystem.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 2023-02260 | NC | |
| Vascular Surgery Physician | 2086S0129X | 2023-02260 | NC | Yes |
Addresses
Primary practice location
111 W Grover St
Shelby, NC 28150-3824
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Other practice location 1
10650 Park Rd
Charlotte, NC 28210-8538
Phone (704) 667-3840
Other practice location 2
100 Medical Park Dr
Ste 210
Concord, NC 28025-2948
Phone (704) 403-6100
Other practice location 3
447 McAlister Rd
Ste 3200
Lincolnton, NC 28092-4114
Phone (980) 212-6300
Other practice location 4
1550 Faulk St
Ste 3100
Monroe, NC 28112-5086
Phone (704) 667-3410
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | faliecusson2783127@CarolinasHealthcareSystem.direct-ci.com | Atrium Health | |
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
Other providers in Shelby, NC
- Alexander Youth Network
- Christina Ann Alexander
- Michael Warren Alexander
- Maham Ali
- Mariam Ali
- All 4 One, LLC
- All About Helping U
- All Care Links
- All Care Links Inc
- All Care Links Inc.
All providers in Shelby, NC · Vascular Surgery Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.