Nicholas John Fustino, M.D.

Primary specialty

Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X

License

39645 Issued in IA

Practice address

1215 Pleasant St Ste 514
Des Moines, IA 50309-1418

Phone

(515) 241-8912

Fax

(515) 241-8988

NPI assigned

May 20, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Pediatric Medicine

Education

University of Massachusetts Medical School, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Iowa Hospital CorporationGroup PAC ID 1052229275, 233 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nfustino10018@direct.unitypoint.org

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.

• Central Iowa Hospital Corporation

  • Family Medicine Physician
  • Des Moines, IA
  • NPI 1104879576
  Medicare reassignment Care Compare group NPD
• Central Iowa Hospital Corporation

  • Pharmacy
  • Des Moines, IA
  • NPI 1003352949
  NPD
• Central Iowa Hospital Corporation

  • Emergency Medicine Physician
  • Des Moines, IA
  • NPI 1770871824
  NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Central Iowa Hospital Corporation

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1396837951
  NPD (past)

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1891952552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091406",
            "telephone_number": "515-241-5926",
            "fax_number": "515-241-5127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 PLEASANT ST STE 514",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091418",
            "telephone_number": "515-241-8912",
            "fax_number": "515-241-8988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Pleasant St",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503091406",
            "country_code": "US",
            "telephone_number": "515-241-5926",
            "fax_number": "515-241-5127",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 Pleasant St",
            "address_2": "Suite 306",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503091453",
            "country_code": "US",
            "telephone_number": "515-241-8912",
            "fax_number": "515-241-8988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUSTINO",
        "first_name": "NICHOLAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "39645",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "IA",
            "license": "39645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "175150097",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891952552",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Craig Fuller, DDS
• Teresa Lorraine Fuller, DO
• Tyler Fulton, OD
• Kevin James Furness, D.O.
• Kate Margaret Furst, PHARMD
• Jerry Futer, LISW
• Loriann Mae Gabel, DO
• Leah Renee Gabriel, NP
• Lisa Gabriel, RN
• Tricia Decontee Gabriel, PMHNP

• Pediatric Hematology & Oncology Physician in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Pediatric Hematology & Oncology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.