Individual provider Active NPI

Bryan Joseph Cusack, DO

  • Pediatrics Physician
  • Red Bank, NJ
National Provider Identifier
1700463536
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MB12424500 Issued in NJ
Practice address
272 Broad St
Red Bank, NJ 07701-2044
Phone
(732) 741-0456
Fax
(732) 219-9477
NPI assigned
Mar 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MB12424500 NJ Primary

Addresses

Primary practice location

272 Broad St
Red Bank, NJ 07701-2044

Mailing address

272 Broad St
Red Bank, NJ 07701-2044
Phone (732) 741-0456

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bryan.cusack@bcdhealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20241015001389 PA Practitioner - Pediatric Medicine 4789088246 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS024159PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services Pediatrics Current Accepting new patients
Pinnacle Health Medical Services CurrentSince Mar 1, 2025 Accepting new patients
Pinnacle Health Medical Services CurrentSince Mar 1, 2025 Accepting new patients
The Milton S Hershey Medical Center Past Accepting new patients
Upmc Pinnacle Hospitals Past Accepting new patients

Locations

111 S Front St
Harrisburg, PA 17101
Phone (717) 782-3282

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

Interoperability endpoints

  • Direct secure messaging: bryan.cusack@nealgittleman.chartmakerdirect.com
  • Direct secure messaging: bcusack@direct.psu.edu

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1700463536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 BROAD ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012044",
            "telephone_number": "732-741-0456",
            "fax_number": "732-219-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 BROAD ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012044",
            "telephone_number": "732-741-0456",
            "fax_number": "732-219-9477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSACK",
        "first_name": "BRYAN",
        "middle_name": "JOSEPH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-26",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MB12424500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bryan.cusack@bcdhealth.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "272 Broad St",
            "city": "Red Bank",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "077012044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

Verify at the official NPI Registry.