Active NPI
Emily Marie Fukuda, PA
- Physician Assistant
- Cincinnati, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50.006108RX
- Practice address
- 3333 Burnet Ave
Cincinnati, OH 45229-3026 - Phone
- (513) 636-4200
- NPI assigned
- Sep 22, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Surgery Physician | 2086S0120X | 50.006108RX | OH | |
| Physician Assistant | 363A00000X | 085.007835 | IL | |
| Physician Assistant | 363A00000X | 50.006108RX | OH | Primary |
Addresses
Primary practice location
3333 Burnet Ave
Cincinnati, OH 45229-3026
Mailing address
3333 Burnet Ave
ML 1013
Cincinnati, OH 45229-3026
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.007835 | IL | MD | Physician Assistant |
| 50.006108RX | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The University of Chicago Medical Center | Current | Accepting new patients | |
| Cardiothoracic & Vascular Surgical Associates S C | Current | Accepting new patients | |
| Children'S Hospital Medical Center | Physician Assistant | Current | Accepting new patients |
| The University of Chicago Medical Center | Current | Accepting new patients |
Locations
150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061
3341 Solutions Ctr
Chicago, IL 60677
10258 Southwest Hwy
Ste A
Chicago Ridge, IL 60415
Phone (708) 346-9533
350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500
120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700
3333 Burnet Ave
#1013
Cincinnati, OH 45229
Phone (513) 636-4200
3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200
Organizations & group practices 4
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.
-
- Pediatrics Physician
- Cincinnati, OH
- NPI 1609915784
Physician Assistant
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1033218128
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Oak Lawn, IL
- NPI 1780679407
-
- Community/Retail Pharmacy
- Calumet City, IL
- NPI 1255895678
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750723200000",
"number": "1356992341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 BURNET AVE",
"address_2": "ML 1013",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452293026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 BURNET AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452293026",
"telephone_number": "513-636-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUKUDA",
"first_name": "EMILY",
"middle_name": "MARIE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-22",
"last_updated": "2025-06-24",
"certification_date": "2025-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "OH",
"license": "50.006108RX",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.007835",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.006108RX",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.