Individual provider Active NPI

Leslie Blanco Cusi Jr., FNP

  • Family Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1760997936
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95008145 Issued in CA
Practice address
1509 Wilson Ter
Glendale, CA 91206
Phone
(818) 863-4000
NPI assigned
Dec 9, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95008145 CA Primary

Addresses

Primary practice location

1509 Wilson Ter
Glendale, CA 91206

Mailing address

1509 Wilson Ter
Glendale, CA 91206-4007
Phone (818) 863-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180806000823 CA Practitioner - Nurse Practitioner 6103174347 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temecula Valley Hospitalist Medical Group IncGroup PAC ID 8224252630, 26 clinicians

Practice addresses (Care Compare)

31700 Temecula Pkwy
Temecula, CA 92592-5896
Phone (951) 331-2200

Hospital & facility affiliations

  • Temecula Valley Hospital Hospital, Temecula, CA, CCN 050775
  • Southwest Healthcare Rancho Springs Hospital Hospital, Murrieta, CA, CCN 050701

Merit-based Incentive Payment System (MIPS)

Final score
95.02 of 100Reported as group
Improvement activities
40
Cost
70.05

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Improvement activities
40
Cost
84.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Corona Hospitalist Medical Group, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Palomar Hospitalist Medical Group, Inc CurrentSince Aug 1, 2021 Accepting new patients
Temecula Valley Hospitalist Medical Group, Inc. CurrentSince May 25, 2018 Accepting new patients

Locations

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

2185 Citracado Pkwy
Escondido, CA 92029
Phone (442) 281-5000

15615 Pomerado Rd
Poway, CA 92064
Phone (858) 613-4000

31700 Temecula Pkwy
Temecula, CA 92592
Phone (951) 303-8939

Organizations & group practices 3

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 2

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": "1512777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1760997936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 WILSON TER",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064007",
            "telephone_number": "818-863-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 WILSON TER",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91206",
            "telephone_number": "818-863-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSI",
        "first_name": "LESLIE",
        "middle_name": "BLANCO",
        "name_suffix": "Jr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-09",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95008145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.