Individual provider Active NPI

Elizabeth Cusumano, NP

  • Adult Health Nurse Practitioner
  • Clinton Township, MI
National Provider Identifier
1265836167
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704259695 Issued in MI
Practice address
42621 Garfield Rd Ste 108
Clinton Township, MI 48038-5031
Phone
(586) 263-3312
Fax
(586) 263-5311
NPI assigned
Oct 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704259695 MI Primary

Addresses

Primary practice location

42621 Garfield Rd Ste 108
Clinton Township, MI 48038-5031

Mailing address

42621 Garfield Rd Ste 108
Clinton Township, MI 48038-5031
Phone (586) 263-3312

Other names 1

  • Elizabeth Daoud Former name

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704259695MIMDAdult Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: ecusumano600413@direct.hfhs.org

NPI Registry JSON

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1265836167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42621 GARFIELD RD STE 108",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385031",
            "telephone_number": "586-263-3312",
            "fax_number": "586-263-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42621 GARFIELD RD STE 108",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385031",
            "telephone_number": "586-263-3312",
            "fax_number": "586-263-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSUMANO",
        "first_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704259695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "DAOUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.