Lydia Ann Fusetti, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD12443 Issued in OR

Practice address

1835 NW Kings Blvd
Corvallis, OR 97330

Phone

(541) 753-3542

Fax

(541) 752-0952

NPI assigned

Jul 31, 2006

Sex

Female

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lfusetti216341@samhealth.direct-ci.com
• Direct secure messaging: lfusetti9034@direct.ohsu.edu

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.

• Albany General Hospital

  • General Acute Care Hospital
  • Albany, OR
  • NPI 1154372340
  Medicare reassignment NPD
• Good Samaritan Hospital Corvallis

  • General Acute Care Hospital
  • Corvallis, OR
  • NPI 1962453134
  Medicare reassignment NPD
• University Professional Services

  • General Practice Physician
  • Portland, OR
  • NPI 1376709535
  Medicare reassignment NPD
• Albany General Hospital

  • Family Medicine Physician
  • Albany, OR
  • NPI 1306679816
  NPD
• Albany General Hospital

  • Physical Medicine & Rehabilitation Physician
  • Albany, OR
  • NPI 1841556008
  NPD
• Good Samaritan Hospital Corvallis

  • Surgery Physician
  • Corvallis, OR
  • NPI 1144596479
  NPD
• Good Samaritan Hospital Corvallis

  • Gynecologic Oncology Physician
  • Corvallis, OR
  • NPI 1710787916
  NPD
• University Professional Services

  • Pharmacy
  • Beaverton, OR
  • NPI 1073054714
  NPD
• University Professional Services

  • Adult Mental Health Clinic/Center
  • Portland, OR
  • NPI 1750753687
  NPD

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1871508374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 NW KINGS BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "97330",
            "telephone_number": "541-753-3542",
            "fax_number": "541-752-0952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 NW KINGS BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "97330",
            "telephone_number": "541-753-3542",
            "fax_number": "541-752-0952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSETTI",
        "first_name": "LYDIA",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2025-04-25",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD12443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268359",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lfusetti216341@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3600 NW Samaritan Dr",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mino Fuller
• Chantell N Fulton
• Tara Fulton
• Joshua A Funk, DPT
• Mira Funk
• Erika Gabonay, LPC
• Tabitha Louise Gadomski, RN
• Candace June Gagnon, THW
• Edward Wilson Gaines
• Andie Marie Gaipo

• Pediatrics Physician in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; 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.