NPIMap

Individual provider Active NPI

Michael Stephen Fusco, MD

  • Internal Medicine Physician
  • Port Chester, NY
National Provider Identifier
1972516482
Registry record updated Sep 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
194064 Issued in NY
Practice address
25 S Regent St
Port Chester, NY 10573-3512
Phone
(914) 939-1922
Fax
(914) 939-5498
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 194064 NY Primary

Addresses

Primary practice location

25 S Regent St
Port Chester, NY 10573-3512

Mailing address

25 S Regent St
Port Chester, NY 10573-3512
Phone (914) 939-1922

Other identifiers 3

IdentifierTypeStateIssuer
194064OtherNYLICENSE
001329813MedicaidCT
032981OtherCTCT LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101129000991 CT Practitioner - Internal Medicine 4981890282 Practice locations: Stamford, CT
I20110221000145 NY Practitioner - Internal Medicine 4981890282 Practice locations: Port Chester, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

25 S Regent St
Port Chester, NY 10573-3512
Phone (914) 939-1922

90 Morgan St
Suite 304
Stamford, CT 06905-5436
Phone (203) 817-0880

Hospital & facility affiliations

  • Visiting Nurse & Hospice of Fairfield County, Inc Home health agency, Wilton, CT, CCN 077074
  • Health Care Connectors LLC Home health agency, Greenwich, CT, CCN 077278
  • Constellation Home Care Home health agency, Norwalk, CT, CCN 077200
  • VNS of Ny Home Care Chha Home health agency, New York, NY, CCN 337008
  • VNS Westchester Chha Home health agency, White Plains, NY, CCN 337146
  • Constellation Home Care Hospice, Norwalk, CT, CCN 071542
  • Greenwich Hospital Association - Hospital, Greenwich, CT, CCN 070018
  • Stamford Hospital Hospital, Stamford, CT, CCN 070006
  • Griffin Hospital Hospital, Derby, CT, CCN 070031
  • Burke Rehabilitation Hospital Inpatient rehabilitation facility, White Plains, NY, CCN 333030
  • Civita Care Center at Long Ridge Nursing home, Stamford, CT, CCN 075394

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
194064NYMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: mfusco6094@direct.ynhh.org
  • Direct secure messaging: michael.fusco.1@32723.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Civita Care Center at Long RidgeStamford, CT, CCN 075394 Skilled nursing facility Adp of the SNF Jan 10, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Hospital & facility affiliations 12

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1972516482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 S REGENT ST",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105733512",
            "telephone_number": "914-939-1922",
            "fax_number": "914-939-5498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 S REGENT ST",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105733512",
            "telephone_number": "914-939-1922",
            "fax_number": "914-939-5498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSCO",
        "first_name": "MICHAEL",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "194064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "194064",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001329813",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT LICENSE",
            "identifier": "032981",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Chester, NY

Sources for this page

Verify at the official NPI Registry.