Jonathan R Fugo-Tutalo, D.O.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

260705 Issued in NY

Practice address

92 Old Route 9W
Suite 100
New Windsor, NY 12553-5485

Phone

(845) 565-7040

Fax

(845) 565-7060

NPI assigned

Jul 18, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mr. Jonathan R Fugo Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Eastern Orange Ambulatory Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Cornwall, NY
  • NPI 1568583896

  NY

  Medicare reassignment NPD
• Hudson Vista Medical,PC

  • Internal Medicine Physician
  • Cornwall, NY
  • NPI 1659666840

  NY

  Medicare reassignment NPD

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1407056534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 OLD ROUTE 9W",
            "address_2": "SUITE 100",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125535485",
            "telephone_number": "845-565-7040",
            "fax_number": "845-565-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 OLD ROUTE 9W",
            "address_2": "SUITE 100",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125535485",
            "telephone_number": "845-565-7040",
            "fax_number": "845-565-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUGO-TUTALO",
        "first_name": "JONATHAN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-18",
        "last_updated": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "260705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03372070",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JONATHAN",
            "last_name": "FUGO",
            "middle_name": "R",
            "prefix": "MR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Catlynn Frank
• Carol Lenore Frankel, PH.D.
• Jasmine Ann Frederick
• Rebecca Ann Fried, NP
• Cassandra Marie Fugo-Tutalo, FNP-BC
• Heidi Fyrberg, PA-C
• Thomas Gallagher, SLP
• Keiara L Gallodoro
• Balmore Garcia
• Therezabeth Garcia, CCC-SLP

• All providers in New Windsor, NY
• Plastic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.

Verify at the official NPI Registry.