MICHAEL J MCCUSKER P. A.-C NPI 1013096684

NPI Information

  • NPI: 1013096684
  • Provider Name: MICHAEL J MCCUSKER, P. A.-C
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 530 NW 27TH ST
    CORVALLIS, OR
    ZIP 97330
  • Phone: (541) 766-6611

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NPI Details

Michael J Mccusker, P. A.-C is a medical physician assistant in Corvallis, OR. Michael J Mccusker, P. A.-C NPI is 1013096684. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

530 NW 27TH ST
CORVALLIS, OR
ZIP 97330-223
Phone: (541) 766-6611
Fax: (541) 766-6186

The NPI 1013096684 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/3/2006 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedicalPA01335OREGONYes
2207Q00000XFamily MedicineMA052623PENNSYLVANIANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1500634427MEDICAIDOREGON
2PA01335OTHEROREGONOREGON MEDICAL BOARD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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