DR. NICHOLAS JOHN FUSTINO (NPI# 1891952552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891952552 |
| Entity Type | Individual |
| Full Name | DR. NICHOLAS JOHN FUSTINO |
| Credential | M.D. |
| Practice Address |
1215 Pleasant St Ste 514 Des Moines IA 50309-1418 |
| Mailing Address |
1200 Pleasant St Des Moines IA 50309-1406 |
| Practice Telephone | 5152418912 |
| Practice Fax Number | 5152418988 |
| Mailing Telephone | 5152415926 |
| Mailing Fax Number | 5152415127 |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 39645 | IA | Allopathic & Osteopathic Physicians |
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
39645 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | MEDICARE | 175150097 | 01 |
| IA | 1891952552 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1200 Pleasant St, Des Moines, IA 503091406 | 5152415926 | 5152415127 |
| 1215 Pleasant St, Suite 306, Des Moines, IA 503091453 | 5152418912 | 5152418988 |
| Street Address |
1215 PLEASANT ST STE 514 |
| City | DES MOINES |
| State | IA |
| Zip Code | 50309-1418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184062457 | Laura Christine Mccarthy | Pediatrics | 1215 Pleasant St Ste 514, Des Moines, IA 50309-1418 | 2013-06-10 |
| 1336375369 | Samantha L. Mallory | Pediatrics | 1215 Pleasant St Ste 514, Des Moines, IA 50309-1418 | 2009-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972126894 | Marie Danielle Leblanc | Surgery | Anna Blank Building, Level 2, Dept Pediatric Surgery, 1206 Pleasant Street, Des Moines, IA 50309 | 2020-05-27 |
| 1538710421 | Macy Mckendree | Social Worker | 918 Se 11th St., Des Moines, IA 50309 | 2019-09-23 |
| 1750938825 | Paradocs Psychological Services | Clinic/Center | 1400 Walnut St #110, Onyx Business, Des Moines, IA 50309 | 2019-08-22 |
| 1003315011 | Hyvacs, LLC | Durable Medical Equipment & Medical Supplies | 215 10th St Ste 110, Des Moines, IA 50309 | 2018-02-05 |
| 1770005746 | Jacob Michael Boyle | Chiropractor | 500 Sw 7th St Ste 205, Des Moines, IA 50309 | 2017-07-12 |
| 1831646140 | Innovative Transport Enterprise, LLC | Non-emergency Medical Transport (VAN) | 309 Court Ave, Ste 811, Des Moines, Ia, 50309, Ste 811, Des Moines, IA 50309 | 2016-09-02 |
| 1457807000 | Patricia Bularzik | Social Worker | 808 5th Avenue, Des Moines, IA 50309 | 2016-09-01 |
| 1396128492 | Sarah Lynn Cavan | Social Worker | 1301 Center, Eyerly Ball Community Mental Health Center, Des Moines, IA 50309 | 2015-07-07 |
| 1104204056 | Andrea Lynn Jones | Social Worker | 600 E Court Ste 200, Des Moines, IA 50309 | 2015-05-12 |
| 1811388937 | Matthew Zirretta | Physical Therapist | 1515 Linden Street, 1st Floor, Integrated Physical Therapy & Sports Medicine, Des Moines, IA 50309 | 2015-02-11 |
| Find all providers in zip 50309 | ||||
| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598812307 | Wendy Woods-swafford | Pediatrics | 1215 Pleasent St., Ste. 306, Des Moines, IA 50309-1453 | 2007-01-04 |
| 1629050802 | Naser J Al Zein | Pediatrics | 1215 Pleasant St, Suite 300, Des Moines, IA 50309-1416 | 2005-11-15 |
| 1114913985 | Torrey L Mitchell | Pediatrics | 1215 Pleasant St, Suite 300, Des Moines, IA 50309-1416 | 2005-09-27 |
| 1710971478 | Stephen C Elliott | Pediatrics | 1212 Pleasant St, Suite 300, Des Moines, IA 50309-1453 | 2005-09-08 |
| 1508850496 | Stephen R Stephenson | Pediatrics | 1215 Pleasant St., Ste. 306, Des Moines, IA 50309-1453 | 2005-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508243700 | Torin Waters | Pediatrics | 200 Hawkins Dr, Iowa City, IA 52242 | 2015-04-27 |
| 1013350289 | Jamie M Truscott | Pediatrics | 200 Hawkins Dr, Iowa City, IA 52242 | 2013-04-08 |
| 1972739712 | William Terry Iv | Pediatrics | 200 Hawkins Dr, 2520 Jcp, Iowa City, IA 52242-1009 | 2009-06-08 |
| 1619137247 | Arunkumar Jagadishbhai Modi | Pediatrics | 200 Hawkins Dr, Dept of Pediatric Hematology/oncology, Iowa City, IA 52242-1009 | 2008-06-17 |
| 1336321330 | David Jon Gordon | Pediatrics | 200 Hawkins Dr, Department of Pediatric Hematology/oncology, Iowa City, IA 52242-1009 | 2007-11-30 |
| 1194945691 | Anjali A Sharathkumar | Pediatrics | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2007-04-26 |
| 1376530485 | Raymond Tannous | Pediatrics | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2005-10-04 |
| 1689669376 | M Sue Odorisio | Pediatrics | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2005-09-19 |
| City | DES MOINES |
| Zip Code | 50309 |
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| 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.