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DR. JOSEPH CARL FUSCO M.D.
NPI 1992062079
Surgery - Pediatric Surgery in Nashville, TN

Active since April 13, 2012PECOS EnrolledAccepts Medicare Assignment
97.12/100
CMS Quality Rating
3601 THE VANDERBILT CLINIC, NASHVILLE, TN 37232(615) 322-3000 Get Directions Write a Review

NPPES record last updated: March 29, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 16, 2021, Oct 20, 2021, Aug 11, 2021 and 1 more (4 updates tracked since 2019).

About Dr. Joseph Carl Fusco M.d. NPPES

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

DR. JOSEPH CARL FUSCO M.D. (NPI 1992062079) is an individual pediatric surgery provider in Nashville, Tennessee, licensed in Tennessee (64256) and active in the NPI registry since April 2012. He is enrolled in Medicare PECOS, maintains a secondary practice location in Pittsburgh, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1992062079
Entity TypeIndividualMale
Primary Taxonomy2086S0120X
Provider Legal NameDR. JOSEPH CARL FUSCOCredential: M.D.
Location Address3601 THE VANDERBILT CLINICNashville, TN 37232-1334
Mailing Address3841 Green Hills Village Dr Ste 200Nashville, TN 37215-2691 · (615) 936-2000
Phone(615) 322-3000
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateApril 13, 2012
Last NPPES UpdateMarch 29, 20224 updates tracked since enumeration
NPPES CertifiedMarch 29, 2022
✔ NPI 1992062079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0120X
License✔ Licensed in TN · 64256
Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3601 THE VANDERBILT CLINIC, Nashville, TN 37232
Open in Google Maps ↗

Secondary Practice Location 1

Location 14401 Penn Ave Ste 7000Pittsburgh, PA 15224-1334 · Phone (412) 692-7280

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Arkansas Health & Wellness, 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 and accepts Medicare assignment

Dr. Joseph Carl Fusco M.d. 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 ID6507169703
PECOS Enrollment IDI20211026003537
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 Reassignments

2

Medicare enrollment records show Joseph Fusco reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Vanderbilt University Medical Center
0.5 mi
Internal Medicine
1301 22ND AVE S
Nashville, TN 37232
  • Reassigned Medicare billing, Tennessee enrollment
  • 4,711 clinicians in this Medicare group
NPI 1104202761 (615) 936-2000
University Of Pittsburgh Physicians
458 mi
Neurological Surgery
425 W FIFTH ST, EAST LIVERPOOL CITY HOSPITAL
East Liverpool, OH 43920
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 7,114 clinicians in this Medicare group
NPI 1811945793 (330) 386-3195

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

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.12/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.64
Promoting Interoperability100
Improvement Activities40

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.

DR. ENGLISH FLACK MD
Pediatrics (Pediatric Cardiology)
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 37232
Davidson County (615) 322-3000
DANIEL K BARRETT APRN
Nurse Practitioner (Acute Care)
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 37232
Davidson County (615) 322-3000
JACQUELYN L. GARNER PNP
Nurse Practitioner (Pediatrics)
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 37232
Davidson County (615) 322-3000
DR. ROBERT JAMES LENTZ M.D.
Internal Medicine (Pulmonary Disease)
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 37232
Davidson County (615) 322-3000
LYNN HOLLIDAY M.D.
Family Medicine
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 37232
Davidson County (615) 322-3000
DR. HEATHER KRETH PSY.D
Psychologist (Clinical Child & Adolescent)
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 37232
Davidson County (615) 936-2000
AARON WESLEY SCOTT APN
Nurse Practitioner
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 37232
Davidson County (615) 936-2000
DR. COLLEEN M KIERNAN M.D.
Surgery (Surgical Oncology)
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 37232
Davidson County (615) 322-3000

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 Joseph Fusco's NPI number?

The NPI number for Joseph Fusco is 1992062079. It was assigned to this individual provider in the NPPES registry on April 13, 2012.

Where is Joseph Fusco located?

Joseph Fusco practices at 3601 The Vanderbilt Clinic, Nashville, TN 37232. The listed phone number is (615) 322-3000.

What is Joseph Fusco's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

Is Joseph Fusco enrolled in Medicare?

Yes. Joseph Fusco 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.

Which organizations bill Medicare for Joseph Fusco's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Joseph Fusco reassigns Medicare benefits to 2 organizations: Vanderbilt University Medical Center (Nashville, TN) and University Of Pittsburgh Physicians (East Liverpool, OH). Each 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 Joseph Fusco's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Joseph Fusco accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama and Ambetter of North Carolina and 4 other insurers list Joseph 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 Joseph Fusco was last updated on March 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.