Shashidhar Kusuma, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

107122 Issued in FL

Practice address

8430 W Broward Blvd
Suite 200
Plantation, FL 33324-2700

Phone

(954) 472-8355

Fax

(954) 472-8220

NPI assigned

Jul 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1598770430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8430 W BROWARD BLVD",
            "address_2": "SUITE 200",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242700",
            "telephone_number": "954-472-8355",
            "fax_number": "954-472-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8430 W BROWARD BLVD",
            "address_2": "SUITE 200",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242700",
            "telephone_number": "954-472-8355",
            "fax_number": "954-472-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSUMA",
        "first_name": "SHASHIDHAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OH",
            "license": "35088257",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "FL",
            "license": "107122",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "107122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2670104",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandhiya Kumari, MD
• Reana Kunjbehari, OTR/L
• Mini V Kuriakose, NP-C
• Darren Allan Kurtzer, AU.D.
• Charity Kurzman, MED, EDS
• Sergio Kuttler, BS, DDS
• Alexia Kyle Kwiatkowski, PT, DPT, CLT
• Susan Kwiatkowski, PA-C
• L & D Ocean Home Health Care Corp
• Joan Ninon La Salvia, DMD

• Plastic Surgery Physician in Plantation, FL
• Providers in Plantation, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; 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.