Barry Justin Cusack, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

M5678 Issued in ID

Practice address

500 West Fort St
(111)
Boise, ID 83702-4598

Phone

(208) 422-1000

Fax

(208) 422-1319

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720187289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9550 CHELAN AVE",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837141264",
            "telephone_number": "208-375-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WEST FORT ST",
            "address_2": "(111)",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024598",
            "telephone_number": "208-422-1000",
            "fax_number": "208-422-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSACK",
        "first_name": "BARRY",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "ID",
            "license": "M5678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENCE",
            "identifier": "M5678",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Curtis, LMSW
• Mary A Curtis, APRN,BC
• Ronald Mark Curtis, RPH
• Thomas R Curtis, DDS
• Sarah Curtright, NP
• Sorcha M Cusack, PA-C
• Rebecca Lynn Cushing
• Austin R Cushman, M.D.
• Customedica Pharmacy Inc
• A Riley Cutler, DDS

• Geriatric Medicine (Internal Medicine) Physician in Boise, ID
• Providers in Boise, ID by specialty
• Geriatric Medicine (Internal Medicine) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.