Individual provider Active NPI

Michael Fusillo, MD

  • Psychiatry Physician
  • Allegan, MI
National Provider Identifier
1689693020
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MF06869 Issued in MI
Practice address
551 Linn St
Suite 230
Allegan, MI 49010-1595
Phone
(269) 686-4110
Fax
(269) 686-2135
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MF06869 MI Primary

Addresses

Primary practice location

551 Linn St
Suite 230
Allegan, MI 49010-1595

Mailing address

551 Linn St
Suite 230
Allegan, MI 49010-1595
Phone (269) 686-4110

Other identifiers 1

IdentifierTypeStateIssuer
2899543MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20080130000554 MI Practitioner - Psychiatry 6901988831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
State University of New York Downstate Medical Center, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Michigan University School of MedicineGroup PAC ID 7517113954, 76 clinicians

Practice addresses (Care Compare)

1717 Shaffer St
Suite 10
Kalamazoo, MI 49048-1647
Phone (269) 337-6373

Hospital & facility affiliations

  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017

Merit-based Incentive Payment System (MIPS)

Final score
97.1 of 100Reported as group
Quality
85.82
Promoting interoperability
100
Improvement activities
40
Cost
77.4

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MF06869MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Michigan University School of Medicine CurrentSince Aug 23, 2024 Accepting new patients
Michigan State University Kalamazoo Center for Medical Studies PastSince Aug 23, 2024 Accepting new patients

Locations

1000 Oakland Dr
Kalamazoo, MI 49008
Phone (269) 337-4347

1717 Shaffer St
Ste 10
Kalamazoo, MI 49048
Phone (269) 337-6200

Organizations & group practices 2

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

Hospital & facility affiliations 1

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689693020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 LINN ST",
            "address_2": "SUITE 230",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101595",
            "telephone_number": "269-686-4110",
            "fax_number": "269-686-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 LINN ST",
            "address_2": "SUITE 230",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101595",
            "telephone_number": "269-686-4110",
            "fax_number": "269-686-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSILLO",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "MF06869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2899543",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allegan, MI

Sources for this page

Verify at the official NPI Registry.