Michael Joseph Cusatis, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D14500 Issued in MI

Practice address

1507 S. Otsego
Suite B
Gaylord, MI 49735

Phone

(989) 732-4189

Fax

(989) 732-1916

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Michael J. Cusatis DDS PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Gaylord, MI
  • NPI 1518118454
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225756800000",
    "number": "1700805652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 S. OTSEGO",
            "address_2": "SUITE B",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "49735",
            "telephone_number": "989-732-4189",
            "fax_number": "989-732-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 S. OTSEGO",
            "address_2": "SUITE B",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "49735",
            "telephone_number": "989-732-4189",
            "fax_number": "989-732-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSATIS",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2008-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "D14500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID #",
            "identifier": "56910090",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5190276",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia S Crist, LBSW
• Samantha Marie Cronk, AGACNP-BC
• Holly Ayn Cronkright, PAC
• Jennifer L Curl, RN
• William Robert Curtiss, RPH
• D & D Pharmacy
• Justin Dalke
• Daniel & Max, LLC
• Daniel P. Moylan D.D.S. PLLC
• David Gast MDPC

• Oral and Maxillofacial Surgery (Dentist) in Gaylord, MI
• Providers in Gaylord, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.