Individual provider Active NPI

Patrick O Fasusi, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Washington, DC
National Provider Identifier
1952473092
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
MD16434 Issued in DC
Practice address
6323 Georgia Ave NW
Suite 200
Washington, DC 20011-1101
Phone
(202) 291-0126
Fax
(202) 291-0370
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X MD16434 DC Primary

Addresses

Primary practice location

6323 Georgia Ave NW
Suite 200
Washington, DC 20011-1101

Mailing address

6323 Georgia Ave NW
Suite 200
Washington, DC 20011-1101
Phone (202) 291-0126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20190129000587 MD Practitioner - Anesthesiology 1355234147 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD16434DCMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Medical Center, Inc. CurrentSince Jun 20, 2019 Accepting new patients
Grace Medical Center, Inc. CurrentSince Jun 20, 2019 Accepting new patients
Pof Inc PastSince May 1, 1994 Accepting new patients

Locations

2000 W Baltimore St
Baltimore, MD 21223
Phone (410) 362-3075

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952473092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6323 GEORGIA AVE NW",
            "address_2": "SUITE 200",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200111101",
            "telephone_number": "202-291-0126",
            "fax_number": "202-291-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6323 GEORGIA AVE NW",
            "address_2": "SUITE 200",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200111101",
            "telephone_number": "202-291-0126",
            "fax_number": "202-291-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASUSI",
        "first_name": "PATRICK",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "DC",
            "license": "MD16434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.