LUCAS RABENO FASOLO (M.D.) – Internal Medicine Physician, NPI 1154704906

LUCAS RABENO FASOLO (M.D.) is a healthcare provider. based in Brighton, Massachusetts. specializing in Internal Medicine Physician. They hold the professional credentials M.D.. They hold a License No. 264115 (MA). The NPI Number for LUCAS RABENO FASOLO (M.D.) is 1154704906

Main info

Male
Sole Proprietor
18 Years Of Experience
Accepts Medicare Assignment
Name
LUCAS RABENO FASOLO (M.D.)
NPI
1154704906
Phone
(617) 783-0500
Address
495 WESTERN AVE
Enumeration Date
29 June 2015
Last Update Date
29 October 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7816933800
Graduation Year
2008 (18 years ago)
PAC ID
7113269804
Group Practice PAC ID
5294709812
Professional Enrollment ID
I20190429002345
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:10State licenses:3Digital endpointsOther names

Provider Addresses for LUCAS RABENO FASOLO (M.D.)

  • 495 WESTERN AVE

    BRIGHTON, MA 021351007

    Phone: (617) 783-0500

    Type: Mailing

  • 495 Western Ave

    Brighton, MA 021351007

    Phone: (617) 783-0500

    Type: Location

  • 115 Lincoln St

    Framingham, MA 017026358

    Phone: (508) 383-1000

    Type: Location

  • 20801 NW 2ND AVE

    MIAMI, FL 331692103

    Phone: (305) 653-1770

    Fax: (786) 725-3453

    Type: Location

  • 1395 NW 167TH ST

    MIAMI GARDENS, FL 331695710

    Phone: (305) 653-1770

    Fax: (786) 725-3453

    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: 2021-09-23

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
I20210923000668IInternal MedicineFLTBD

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 02135)

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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: 5294709812View full group profile
NameSpecialtyState
Nurse PractitionerMA
-MA
Nurse PractitionerMA
Nurse PractitionerMA
-MA
Physician AssistantMA
Physician AssistantMA
Nurse PractitionerMA
Hospitalist, Internal MedicineMA
Internal MedicineMA

Reviews

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Frequently asked questions

Does LUCAS RABENO FASOLO (M.D.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — LUCAS RABENO FASOLO (M.D.) uses 1154704906.
Does CMS list LUCAS RABENO FASOLO (M.D.) as active?
Yes — LUCAS RABENO FASOLO (M.D.) is active in the NPI listing used on this page.
What taxonomy line describes LUCAS RABENO FASOLO (M.D.)?
For research purposes, treat LUCAS RABENO FASOLO (M.D.) as Internal Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is LUCAS RABENO FASOLO (M.D.) based?
LUCAS RABENO FASOLO (M.D.) is tied to Brighton, Massachusetts in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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