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JACLYN ANN FUSCO
NPI 1063113355
Nurse Practitioner - Pediatrics in South Bend, IN

Active since March 14, 2023PECOS Enrolled
100 NAVARRE PL STE 5550, SOUTH BEND, IN 46601(574) 647-2550 Get Directions Write a Review

NPPES record last updated: April 2, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 2, 2024, Aug 17, 2023, Jul 7, 2023 and 1 more (4 updates tracked since 2023).

About Jaclyn Ann Fusco NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACLYN ANN FUSCO (NPI 1063113355) is an individual pediatrics provider in South Bend, Indiana, licensed in Indiana (202325197) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063113355
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameJACLYN ANN FUSCO
Location Address100 NAVARRE PL STE 5550South Bend, IN 46601-1169
Mailing Address3245 Health Dr Ste 100Granger, IN 46530-1380 · (574) 647-2129
Phone(574) 647-2550
Sole ProprietorNo
Enumeration DateMarch 14, 2023
Last NPPES UpdateApril 2, 20244 updates tracked since enumeration
NPPES CertifiedApril 2, 2024
✔ NPI 1063113355 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in IN · 202325197
Also ListedRegistered NurseTaxonomy 163W00000X · License 28265298A (IN)
100 NAVARRE PL STE 5550, South Bend, IN 46601
Open in Google Maps ↗

Other Identifiers 1

Medicaid300078118IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jaclyn Ann Fusco is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jaclyn Fusco reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Beacon Medical Group, Inc.
Same address
Pediatrics
100 NAVARRE PL STE 5550
South Bend, IN 46601
  • Reassigned Medicare billing, Indiana enrollment
  • 734 clinicians in this Medicare group
NPI 1548415474 (574) 647-2550

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46601 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASAD ANSARI MD
Pediatrics (Pediatric Pulmonology)
100 NAVARRE PL STE 5550
SOUTH BEND, IN 46601
St. Joseph County (574) 647-2550
LAURA M. SNYDER CPNP-CP
Nurse Practitioner (Pediatrics)
100 NAVARRE PL STE 5550
SOUTH BEND, IN 46601
St. Joseph County (574) 647-2550
SAMIRA HASSAN EL-ZIND MD
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
100 NAVARRE PL STE 5550
SOUTH BEND, IN 46601
St. Joseph County (574) 647-2550
HEATHER LORENE SOLFRONK RD
Dietitian, Registered
100 NAVARRE PL STE 5550
SOUTH BEND, IN 46601
St. Joseph County (574) 647-2550
LAURA LYNN JORDAN RD, CD
Dietitian, Registered
100 NAVARRE PL STE 5550
SOUTH BEND, IN 46601
St. Joseph County (574) 647-2550
VICKIE CRAKER RD,CSP,CD
Dietitian, Registered
100 NAVARRE PL STE 5550
SOUTH BEND, IN 46601
St. Joseph County (574) 647-2550
MS. REBECCA KATHLEEN KELLN PA-C
Physician Assistant
100 NAVARRE PL STE 5550
SOUTH BEND, IN 46601
St. Joseph County (574) 647-2550
BEACON MEDICAL GROUP, INC.
Pediatrics
100 NAVARRE PL STE 5550
SOUTH BEND, IN 46601
St. Joseph County (574) 647-2550

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jaclyn Fusco's NPI number?

The NPI number for Jaclyn Fusco is 1063113355. It was assigned to this individual provider in the NPPES registry on March 14, 2023.

Where is Jaclyn Fusco located?

Jaclyn Fusco practices at 100 Navarre Pl Ste 5550, South Bend, IN 46601. The listed phone number is (574) 647-2550.

What is Jaclyn Fusco's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Jaclyn Fusco enrolled in Medicare?

Yes. Jaclyn Fusco is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jaclyn Fusco's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jaclyn Fusco reassigns Medicare benefits to Beacon Medical Group, Inc. (South Bend, IN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jaclyn Fusco's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jaclyn Fusco accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Jaclyn Fusco as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jaclyn Fusco was last updated on April 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.