Individual provider Active NPI

David M Caruso, MD

  • Family Medicine Physician
  • Saint Marys, PA
National Provider Identifier
1427052117
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD022209E Issued in PA
Practice address
761 Johnsonburg Road
Suite 240
St Marys, PA 15857-1349
Phone
(814) 834-6565
Fax
(814) 834-7424
NPI assigned
Jun 9, 2005
Last updated
Jan 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD022209E PA Primary

Addresses

Primary practice location

761 Johnsonburg Road
Suite 240
St Marys, PA 15857-1349

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 837-5402

Other identifiers 1

IdentifierTypeStateIssuer
8085210001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD022209EPAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1427052117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-837-5402",
            "fax_number": "814-837-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 JOHNSONBURG ROAD",
            "address_2": "SUITE 240",
            "city": "ST MARYS",
            "state": "PA",
            "postal_code": "158571349",
            "telephone_number": "814-834-6565",
            "fax_number": "814-834-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARUSO",
        "first_name": "DAVID",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD022209E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8085210001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; 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.