Jodi B Cusack
Physician Assistant

Address: 1150 Reservoir Ave Ste 201, Cranston, RI 02920
Phone: 4019431300

Jodi B Cusack (NPI# 1306128251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1306128251
Entity Type Individual
Full Name Jodi B Cusack
Credential PA-C
Gender Female
Practice Address 1150 Reservoir Ave Ste 201
Cranston
RI 02920
Practice Telephone 4019431300
Practice Fax Number 4012287109
Mailing Address 1150 Reservoir Ave Ste 201
Cranston
RI 02920-6043
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2011-09-16
Last Update Date 2018-06-29

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers

Secondary Practice Locations

Address Telephone Number Fax Number
360 Kingstown Rd Ste 202, Narragansett, RI 028823239 4017891860 4012287109

Physician Overview

NPI 1306128251
PAC ID by PECOS 0840451548
Professional Enrollment ID I20120405000171
Full Name Jodi B Cusack
Organization Legal Name INTERNAL MEDICINE ASSOC INC
Phone Number 4017891860
Gender F
Graduation Year 2011
Primary Specialty PHYSICIAN ASSISTANT
Group Practice PAC ID 9234029257
Number of Group Practice Members 9
Accepts Medicare Assignment Y
Report Quality Measures Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
410008 SOUTH COUNTY HOSPITAL INC
410005 OUR LADY OF FATIMA HOSPITAL

Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1285042671 Michelle Jacques Physician Assistant 2000 Chapel View Blvd Ste 225, Cranston, RI 02920-3087 2014-07-29
1093121642 Kathleen Salisbury Physician Assistant 75 Sockanosset Cross Rd Ste 100, Cranston, RI 02920-5558 2014-07-03
1477520906 Andrew Macko Physician Assistant 1150 New London Ave, Cranston, RI 02920-3036 2006-03-03
1730177502 Cynthia Ann Fahey Physician Assistant 725 Reservoir Ave Ste 6a, Cranston, RI 02910-4450 2005-10-06
1790343747 Billie Burke Physician Assistant 333 Budlong Rd, Cranston, RI 02920-6337 2019-06-04
1790141976 Jacklyn Bradley Physician Assistant 333 Budlong Rd, Cranston, RI 02920-6337 2016-01-04
1114361623 Grace Barber Physician Assistant 2000 Chapel View Blvd, Suite 225, Cranston, RI 02920-3078 2013-04-26
1023273893 Leanne M Nadeau Physician Assistant 333 Budlong Rd, Cranston, RI 02920-6337 2008-07-22
1154443976 Jennifer Lynn Geremia Physician Assistant 1150 Reservoir Avenue, Suite 201, Cranston, RI 02920-6068 2007-04-04
1245242395 Robert Pearlman Physician Assistant 725 Reservoir Ave, Cranston, RI 02910-4448 2006-08-13
Find all providers in CRANSTON

Office Location

Street Address 1150 RESERVOIR AVE STE 201
City CRANSTON
State RI
Zip Code 02920

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1164923553 Codac Inc Peer Specialist 3 Regan Ct, Cranston, RI 02920 2018-02-22
1760991483 Jennifer Marie Pirrello Occupational Therapist 150 Midway Road, Suite 173, Cranston, RI 02920 2017-09-26
1144673096 Joanne Le Optometrist 1400 Oaklawn Ave., Cranston, RI 02920 2016-07-15
1053790733 Alanna Conley Speech-Language Pathologist 45 Sockanosset Cross Rd Ste 100, Cranston, RI 02920 2015-05-27
1114322740 Nicole Enos Physical Therapist 51 Sockanosset Crossroad, Cranston, RI 02920 2014-10-24
1386086403 Sarah Gonzalez Marriage & Family Therapist 105 Sockanosset Cross Rd Ste 102, Cranston, RI 02920 2013-07-18
1902246788 Amanda Lee Zarriello Physical Medicine & Rehabilitation 10 Worthington Rd, Cranston, RI 02920 2013-06-26
1962742528 Yatyee Lee Counselor 141 Elmwood Avenue, Cranston, RI 02920 2013-02-19
1710270681 Annmarie Devine Pharmacist 1011 Cranston St, Cranston, RI 02920 2011-05-25
1922310002 Natalia M Marks Radiology 65 Sockanosset Crossroad, Cranston, RI 02920 2010-07-06
Find all providers in zip 02920

Competitor

Search similar providers

City CRANSTON
Zip Code 02920

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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