Active NPI
Eric Frusciante, D.M.D.
- Dentist
- Forty Fort, PA
National Provider Identifier
1265837751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS040220
- Practice address
- 920 Wyoming Ave
Suite 104
Forty Fort, PA 18704-3953 - Phone
- (570) 283-2422
- NPI assigned
- Oct 27, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | DS040220 | PA | Primary |
Addresses
Primary practice location
920 Wyoming Ave
Suite 104
Forty Fort, PA 18704-3953
Mailing address
920 Wyoming Ave
Suite 104
Forty Fort, PA 18704-3953
Phone (570) 283-2422
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150605001454 | PA | Order and Referring Only - Dentist | 8123349875 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS040220 | PA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nepa Dental Group, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Forty Fort, PA
- NPI 1669082632
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414368000000",
"number": "1265837751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 WYOMING AVE",
"address_2": "SUITE 104",
"city": "FORTY FORT",
"state": "PA",
"postal_code": "187043953",
"telephone_number": "570-283-2422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 WYOMING AVE",
"address_2": "SUITE 104",
"city": "FORTY FORT",
"state": "PA",
"postal_code": "187043953",
"telephone_number": "570-283-2422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRUSCIANTE",
"first_name": "ERIC",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-10-27",
"last_updated": "2014-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS040220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forty Fort, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.