FAIZ ENDRO KUSUMO MD
NPI 1619461696
Student in an Organized Health Care Education/Training Program in Fresno, CA
About Faiz Endro Kusumo Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FAIZ ENDRO KUSUMO MD (NPI 1619461696) is an individual student in an organized health care education/training program in Fresno, California and active in the NPI registry since June 2018. He is enrolled in Medicare PECOS and is a graduate of University Of Southern California Keck School Of Medicine (2018).
NPPES Registry Identity
Specialties & Licenses
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
Faiz Endro Kusumo 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.
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.
FRESNO, CA 93720
FRESNO, CA 93720
FRESNO, CA 93720
FRESNO, CA 93720
FRESNO, CA 93720
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 Faiz Kusumo's NPI number?
The NPI number for Faiz Kusumo is 1619461696. It was assigned to this individual provider in the NPPES registry on June 21, 2018.
Where is Faiz Kusumo located?
Faiz Kusumo practices at 1313 E Herndon Ave, Fresno, CA 93720. The listed phone number is (559) 450-5375.
What is Faiz Kusumo's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Faiz Kusumo enrolled in Medicare?
Yes. Faiz Kusumo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
When was this NPI record last updated?
The NPPES record for Faiz Kusumo was last updated on June 21, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Faiz Endro Kusumo, MD · NPI 1619461696
Student in an Organized Health Care Education/Training Program provider in Fresno, California. Individual provider, active in the CMS NPPES registry since June 21, 2018.
## Identity
- **NPI:** 1619461696 (Entity type: Individual)
- **Enumerated:** June 21, 2018
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1313 E HERNDON AVE, Fresno, CA 93720-3306
- **Phone:** (559) 450-5375
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** University Of Southern California Keck School Of Medicine, class of 2018
## Record status
- **NPPES last updated:** June 21, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1619461696) · Data from the CMS NPPES public registry.