Jodi B Cusack, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1150 Reservoir Ave Ste 201
Cranston, RI 02920

Phone

(401) 943-1300

Fax

(401) 228-7109

NPI assigned

Sep 16, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9000/brand/5/csg/1/fhir/r4

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.

• New University Medical Group LLC

  • Internal Medicine Physician
  • Providence, RI
  • NPI 1083012173
  NPD
• University Gastroenterology, LLC

  • Gastroenterology Physician
  • Providence, RI
  • NPI 1386952612
  NPD (past)

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

{
    "created_epoch": "1316131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1306128251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 RESERVOIR AVE STE 201",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029206043",
            "telephone_number": "401-943-1300",
            "fax_number": "401-228-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 RESERVOIR AVE STE 201",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "02920",
            "telephone_number": "401-943-1300",
            "fax_number": "401-228-7109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 Kingstown Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Narragansett",
            "state": "RI",
            "postal_code": "028823239",
            "country_code": "US",
            "telephone_number": "401-789-1860",
            "fax_number": "401-228-7109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUSACK",
        "first_name": "JODI",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-16",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrian Miguel Cruz Taveras, MSW
• Cruzcare1
• Chriselly M Cuadrado
• Edward L Cullen, M.D.
• Miranda Cummings, MA
• Marissa Cushman, PT
• Christopher Cutler, MASTERS
• Taylor Cutolo
• Patricia Cyr
• Peter John D Allesandro, DDS

• Physician Assistant in Cranston, RI
• Providers in Cranston, RI by specialty
• Physician Assistant in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; 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.