Carrie Ann R Cusack, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD422137 Issued in PA

Practice address

219 N Broad St
4TH Floor
Philadelphia, PA 19107-1519

Phone

(215) 762-5550

Fax

(215) 762-5570

NPI assigned

May 1, 2006

Last updated

Aug 31, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 enrollments

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 2

Specialty

DermatologyAlso: Pathology

Education

Jefferson Medical College of Thomas Jefferson University, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Associates of South Jersey, L.L.C.Group PAC ID 7113016858, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ccusack@dasj.emadirect.md
• Direct secure messaging: ccusack@dermasj.curemd.direct-ci.com

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.

• Dermatology Associates of South Jersey, L.L.C.

  • Dermatopathology Physician
  • Mount Laurel, NJ
  • NPI 1699960096

  Dermatology

  Medicare reassignment Care Compare group NPD Authorized official
• Drexel University

  dba Drexel Psychology

  • Psychologist
  • Philadelphia, PA
  • NPI 1902900095
  Medicare reassignment NPD
• Drexel University

  dba Pennsylvania Ear Institute

  • Audiologist
  • Elkins Park, PA
  • NPI 1104822253
  NPD
• Drexel University

  dba Drexel ID Partnership Clinic SPEC

  • Infectious Disease Physician
  • Philadelphia, PA
  • NPI 1154590933
  NPD
• Dermatology Physicians of South Jersey, PA

  • Dermatopathology Physician
  • Mount Laurel, NJ
  • NPI 1124185004
  NPD (past)

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1649238775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST",
            "address_2": "SUITE 11511",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021320",
            "telephone_number": "215-255-7822",
            "fax_number": "215-255-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N BROAD ST",
            "address_2": "4TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071519",
            "telephone_number": "215-762-5550",
            "fax_number": "215-762-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSACK",
        "first_name": "CARRIE ANN",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD422137",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA07815500",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "PA",
            "license": "MD422137",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "NJ",
            "license": "25MA07815500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001967148",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay A Curtis, M.D.
• Mark T. Curtis
• Stephanie C Curtis, CPNP-PC
• Jillian Curtiss, LMFT
• Lasonya Denise Curtiss, M.ED.
• Kevin Cush
• Leon Edward Cushenberry Jr.
• Herbert E Cushing III, M.D.
• Katherine Cushing, D.M.D.
• Brittany Custer, DO

• Dermatology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.