Individual provider Active NPI

Nicole Ann Fusco-Evans, RN

  • Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1972747129
Registry record updated Apr 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
611422 Issued in NY
Practice address
8301 Ridge Blvd
Apt 2H
Brooklyn, NY 11209-4329
Phone
(516) 241-8448
NPI assigned
Apr 30, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 611422 NY Primary

Addresses

Primary practice location

8301 Ridge Blvd
Apt 2H
Brooklyn, NY 11209-4329

Mailing address

8301 Ridge Blvd
Apt 2H
Brooklyn, NY 11209-4329
Phone (516) 241-8448

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
611422NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241049600000",
    "number": "1972747129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 RIDGE BLVD",
            "address_2": "APT 2H",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094329",
            "telephone_number": "516-241-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 RIDGE BLVD",
            "address_2": "APT 2H",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094329",
            "telephone_number": "516-241-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSCO-EVANS",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-30",
        "last_updated": "2009-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "611422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.