Individual provider Active NPI

Jelena Cusanelli

  • Pharmacist
  • Bradenton, FL
National Provider Identifier
1639568090
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PSI 29692 Issued in FL
Practice address
5060 Newport News Cir
Bradenton, FL 34211-8402
Phone
(321) 446-0944
NPI assigned
Jan 22, 2015
Sex
Female
Sole proprietor
Yes

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
Pharmacist 183500000X PSI 29692 FL Primary

Addresses

Primary practice location

5060 Newport News Cir
Bradenton, FL 34211-8402

Mailing address

5060 Newport News Cir
Bradenton, FL 34211-8402

Other identifiers 1

IdentifierTypeStateIssuer
PSI 29692OtherFLSTATE OF FLORIDA DEPARTMENT OF HEALTH

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSI 29692FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1639568090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 NEWPORT NEWS CIR",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342118402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5060 NEWPORT NEWS CIR",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342118402",
            "telephone_number": "321-446-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSANELLI",
        "first_name": "JELENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PSI 29692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA DEPARTMENT OF HEALTH",
            "identifier": "PSI 29692",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

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.