Individual provider Active NPI

Angela Cusumano, PA

  • Physician Assistant
  • Astoria, NY
National Provider Identifier
1376988154
Registry record updated May 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
015910 Issued in NY
Practice address
2318 31St St
Suite 320
Astoria, NY 11105-2765
Phone
(718) 728-9822
NPI assigned
May 7, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 015910 NY Primary

Addresses

Primary practice location

2318 31St St
Suite 320
Astoria, NY 11105-2765

Mailing address

994 Polk Ave
Franklin Square, NY 11010-2018
Phone (516) 652-4946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170925001641 NY Practitioner - Physician Assistant 4082988407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Simply Dermatology PLLCGroup PAC ID 5193082006, 3 clinicians

Practice addresses (Care Compare)

900 Walt Whitman Rd
Suite 101
Melville, NY 11747-2215
Phone (631) 377-7222

Merit-based Incentive Payment System (MIPS)

Final score
98.15 of 100Reported as group
Quality
96.3
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
015910NYMDPsychologist

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

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.

NPI Registry JSON

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367884800000",
    "number": "1376988154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "994 POLK AVE",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110102018",
            "telephone_number": "516-652-4946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2318 31ST ST",
            "address_2": "SUITE 320",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052765",
            "telephone_number": "718-728-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSUMANO",
        "first_name": "ANGELA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-07",
        "last_updated": "2013-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

Verify at the official NPI Registry.