JUSTIN CUSUMANO (MA) – Mental Health Counselor, NPI 1104308675

JUSTIN CUSUMANO (MA) is a healthcare provider. based in West melbourne, Florida. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA. The NPI Number for JUSTIN CUSUMANO (MA) is 1104308675

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
JUSTIN CUSUMANO (MA)
NPI
1104308675
Phone
(321) 676-6650
Address
2000 COMMERCE DR
Enumeration Date
31 August 2018
Last Update Date
21 October 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3217799838
Graduation Year
2020 (6 years ago)
PAC ID
9830624451
Group Practice PAC ID
0042403610
Professional Enrollment ID
I20241119004489
Address ID
FL329407323ME5545XRDXX414
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:7State licenses:0Digital endpointsOther names

3,018 MENTAL HEALTH COUNSELOR in FL

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Provider Addresses for JUSTIN CUSUMANO (MA)

  • Commerce Drive, Melbourne, Brevard County, Florida, 32910, United States

    WEST MELBOURNE, FL 329042335

    Phone: (321) 676-6650

    Type: Location

  • 5545 N WICKHAM RD STE 110

    MELBOURNE, FL 329407323

    Phone: (321) 872-4660

    Type: Location

  • Circles of Care, 400, East Sheridan Road, Melbourne, Brevard County, Florida, 32901, United States

    MELBOURNE, FL 32901

    Phone: (321) 722-5200

    Type: Mailing

  • 3466 FORT NELSON LN

    MELBOURNE, FL 329342902

    Phone: (321) 872-4660

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241119004489IMental Health CounselorFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32904)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0042403610View full group profile
NameSpecialtyState
Mental Health CounselorFL
Pediatric Medicine, PsychiatryFL
Nurse PractitionerFL
Nurse PractitionerFL
Clinical Social WorkerFL
Clinical Social WorkerFL
Clinical Social WorkerFL
Mental Health CounselorFL
-FL
Nurse PractitionerFL

Reviews

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Frequently asked questions

How is JUSTIN CUSUMANO (MA) identified in CMS data?
CMS-hosted NPPES data lists JUSTIN CUSUMANO (MA) with NPI 1104308675.
Is JUSTIN CUSUMANO (MA) listed as active for patients and plans?
The listing shows JUSTIN CUSUMANO (MA) as active in the NPI system.
What is JUSTIN CUSUMANO (MA)'s specialty?
The listing groups JUSTIN CUSUMANO (MA) with Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What area does JUSTIN CUSUMANO (MA) serve?
JUSTIN CUSUMANO (MA)'s listing highlights West Melbourne, Florida; more addresses can appear in NPPES.
Is the information about JUSTIN CUSUMANO (MA) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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