Active NPI
Gregg J Fasulo, MD
- Orthopaedic Surgery Physician
- Lancaster, PA
National Provider Identifier
1881695245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- MD037209E
- Practice address
- 231 Granite Run Dr
Lancaster, PA 17601-6823 - Phone
- (717) 560-4200
- Fax
- (717) 560-4159
- NPI assigned
- Aug 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MD037209E | PA | Primary |
Addresses
Primary practice location
231 Granite Run Dr
Lancaster, PA 17601-6823
Mailing address
231 Granite Run Dr
Lancaster, PA 17601-6823
Phone (717) 560-4200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 746272 | Other | PA | HIGHMARK BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD037209E | PA | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200355200000",
"number": "1881695245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "231 GRANITE RUN DR",
"city": "LANCASTER",
"state": "PA",
"postal_code": "176016823",
"telephone_number": "717-560-4200",
"fax_number": "717-560-4159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "231 GRANITE RUN DR",
"city": "LANCASTER",
"state": "PA",
"postal_code": "176016823",
"telephone_number": "717-560-4200",
"fax_number": "717-560-4159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FASULO",
"first_name": "GREGG",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-09",
"last_updated": "2008-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "PA",
"license": "MD037209E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "746272",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lancaster, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.