Individual provider Active NPI

Gregory Cusano, DO

  • Anatomic Pathology & Clinical Pathology Physician
  • Fort Worth, TX
National Provider Identifier
1508863838
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
L4319 Issued in TX
Practice address
1401 Pennsylvania Ave
Fort Worth, TX 76104-2113
Phone
(713) 432-1100
Fax
(713) 432-0221
NPI assigned
Jul 1, 2005
Last updated
Dec 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Pathology) Physician 207ZH0000X L4319 TX
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X L4319 TX Primary

Addresses

Primary practice location

1401 Pennsylvania Ave
Fort Worth, TX 76104-2113

Mailing address

14275 Midway Rd Ste 400
Addison, TX 75001-3661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20120222000445 TX Practitioner - Pathology 6406014497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Nova Southeastern Univ College of Dental Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1401 Pennsylvania Ave
Fort Worth, TX 76104-2113
Phone (817) 250-5630

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L4319TXMDHematology (Pathology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ameripath Lubbock 501a Corporation Anatomic Pathology & Clinical Pathology Current Accepting new patients
Ameripath Lubbock 5.01(a) Corporation Anatomic Pathology & Clinical Pathology CurrentSince Oct 31, 2019 Accepting new patients
Ameripath Lubbock 501a Corporation Past Accepting new patients

Locations

14275 Midway Rd
Ste 400
Addison, TX 75001
Phone (214) 932-8018

108 Denver Trl
Azle, TX 76020
Phone (817) 444-8600

10864 Texas Health Trl
Fort Worth, TX 76244
Phone (682) 212-2000

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

1401 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-5630

2118 Broadway
Lubbock, TX 79401
Phone (806) 785-7903

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1508863838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD STE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013661",
            "fax_number": "610-271-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042113",
            "telephone_number": "713-432-1100",
            "fax_number": "713-432-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSANO",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "TX",
            "license": "L4319",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "L4319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.