Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

BRADLEY JACOB FASULO MD
NPI 1558002014
Pediatrics in Richmond, VA

Q: What is Bradley Fasulo's NPI number?

The NPI number for Bradley Fasulo is 1558002014. It was assigned to this individual provider in the NPPES registry on April 6, 2022.

Q: What is Bradley Fasulo's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Bradley Fasulo was last updated on July 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 32 days 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.

Active since April 06, 2022PECOS EnrolledAccepts Medicare Assignment

1000 E BROAD ST, RICHMOND, VA 23219(804) 828-2467(804) 828-5775 Get Directions Write a Review

NPPES record last updated: July 5, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 7, 2025, Jun 30, 2025, Jun 13, 2024 and 1 more (4 updates tracked since 2022).

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About Bradley Jacob Fasulo Md NPPES

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

BRADLEY JACOB FASULO MD (NPI 1558002014) is an individual pediatrics provider in Richmond, Virginia, licensed in Virginia (0101285209) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS, maintains a secondary practice location in Richmond, and is a graduate of Virginia Commonwealth University, School Of Medicine (2022).

NPPES Registry Identity

NPI1558002014

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameBRADLEY JACOB FASULOCredential: MD

Location Address1000 E BROAD STRichmond, VA 23219-1930

Mailing AddressPo Box 980257Richmond, VA 23298-0257 · (804) 828-9783

Phone(804) 828-2467

Fax(804) 828-5775

Sole ProprietorNo

Medical School CMSVirginia Commonwealth University, School Of MedicineGraduated 2022

Enumeration DateApril 6, 2022

Last NPPES UpdateJuly 5, 20264 updates tracked since enumeration

NPPES CertifiedJuly 5, 2026

✔ NPI 1558002014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in VA · 0101285209

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1000 E BROAD ST, Richmond, VA 23219

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Secondary Practice Location 1

Location 11250 E Marshall StRichmond, VA 23298-5023 · Phone (804) 828-2467 · Fax (804) 628-5847

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Bradley Jacob Fasulo Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4789068321

PECOS Enrollment IDI20250825004132

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23219 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

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$99.13 typical visit price

range $18.07 – $138.91

Typical copayment $24.78 (range $4.51 – $34.72)

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 20

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

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