Individual provider Active NPI

Michael Cusick, MD, MHSA

  • Retina Specialist (Ophthalmology) Physician
  • Charlottesville, VA
National Provider Identifier
1275670291
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
0101269475 Issued in VA
Practice address
1300 Jefferson Park Ave
Charlottesville, VA 22903-3363
Phone
(434) 924-5485
Fax
(434) 244-9436
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD-439428 PA
Ophthalmology Physician 207W00000X 0101269475 VA
Retina Specialist (Ophthalmology) Physician 207WX0107X MD-439428 PA
Retina Specialist (Ophthalmology) Physician 207WX0107X 0101269475 VA Primary

Addresses

Primary practice location

1300 Jefferson Park Ave
Charlottesville, VA 22903-3363

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007

Other practice location 1

1215 Lee St
Charlottesville, VA 22908-3363
Phone (434) 924-0211

Other identifiers 1

IdentifierTypeStateIssuer
102474527MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcusick455997@direct.healthsystem.virginia.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200702001755 VA Practitioner - Ophthalmology 7719059567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Georgetown University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Virginia Physicians GroupGroup PAC ID 4880590728, 1,685 clinicians

Practice addresses (Care Compare)

1300 Jefferson Park Ave
FL 4
Charlottesville, VA 22903-3363
Phone (434) 924-5125

Hospital & facility affiliations

  • University of Virginia Medical Center Hospital, Charlottesville, VA, CCN 490009
  • Houston Methodist Hospital Hospital, Houston, TX, CCN 450358

Merit-based Incentive Payment System (MIPS)

Final score
86.45 of 100Reported as group
Quality
79.76
Promoting interoperability
100
Improvement activities
40
Cost
75.07

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-439428PAMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince May 1, 2020 Accepting new patients

Locations

1300 Jefferson Park Ave
Fl 4
Charlottesville, VA 22903
Phone (434) 924-5125

1300 Jefferson Park Ave
Charlottesville, VA 22903
Phone (434) 924-2241

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

2955 Ivy Rd
Charlottesvle, VA 22903
Phone (434) 980-6555

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1275670291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 JEFFERSON PARK AVE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229033363",
            "telephone_number": "434-924-5485",
            "fax_number": "434-244-9436"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229083363",
            "country_code": "US",
            "telephone_number": "434-924-0211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUSICK",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD, MHSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD-439428",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101269475",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "PA",
            "license": "MD-439428",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "VA",
            "license": "0101269475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102474527",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcusick455997@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1300 Jefferson Park Ave",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229033363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.