MR. JUSTIN JOSEPH FAZIO (M.D.) – MOHS-Micrographic Surgery Physician, NPI 1154853083

MR. JUSTIN JOSEPH FAZIO (M.D.) is a healthcare provider. based in Milwaukee, Wisconsin. specializing in DERMATOLOGY, MICROGRAPHIC DERMATOLOGIC SURGERY (MDS). They hold the professional credentials M.D.. They hold a License No. A174428 (CA). The NPI Number for MR. JUSTIN JOSEPH FAZIO (M.D.) is 1154853083

Main info

Male
Sole Proprietor
9 Years Of Experience
Name
MR. JUSTIN JOSEPH FAZIO (M.D.)
NPI
1154853083
Phone
Not provided
Address
143 N BROADWAY
Enumeration Date
30 March 2017
Last Update Date
27 September 2023

Doctor Profile

Medical School Name
CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9164921828
Graduation Year
2017 (9 years ago)
PAC ID
4486007564
Group Practice PAC ID
0749221000
Professional Enrollment ID
I20240124004245
Address ID
CA958154801SA1525XRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:9State licenses:1Digital endpointsOther names

2,140 DERMATOLOGY in CA

Provider Addresses for MR. JUSTIN JOSEPH FAZIO (M.D.)

  • North Broadway, East Town, Milwaukee, Milwaukee County, Wisconsin, 53202, United States

    SECOND FLOOR

    MILWAUKEE, WI 532026016

    Phone:

    Type: Mailing

  • 2805 J STREET

    SUITE 100

    SACRAMENTO, CA 95816

    Phone: (916) 492-1828

    Fax: (916) 492-1834

    Type: Location

  • Aurora Saint Luke's Medical Center, 2900, West Oklahoma Avenue, Southgate, Milwaukee, Milwaukee County, Wisconsin, 53215, United States

    MILWAUKEE, WI 532154330

    Phone: (414) 649-3323

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 17 Open Payments records for all available years, with a total value of $1,889.

Total Amount is formed as General ($1,889) + Research ($0) + Ownership ($0) = $1,889.

Last reported payment date: 2024-12-10 • Largest payer in this snapshot: SUN PHARMACEUTICAL INDUSTRIES INC. ($287).

Total Amount

$1,889

General + Research + Ownership

Payments

17

Total payment records

General Amount

$1,889

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-10

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2024-01-24

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
I20240124004245IDermatologyCATBD

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 53202)

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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: 0749221000View full group profile
NameSpecialtyState
-CA

Reviews

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Frequently asked questions

Can I cross-check MR. JUSTIN JOSEPH FAZIO (M.D.) using NPI 1154853083?
NPI 1154853083 belongs to MR. JUSTIN JOSEPH FAZIO (M.D.); compare other details if you need extra assurance.
Is MR. JUSTIN JOSEPH FAZIO (M.D.) still an active registrant?
MR. JUSTIN JOSEPH FAZIO (M.D.) carries an active NPI according to the public dataset.
What expertise is attributed to MR. JUSTIN JOSEPH FAZIO (M.D.)?
MR. JUSTIN JOSEPH FAZIO (M.D.)'s specialty line reads MOHS-Micrographic Surgery Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MR. JUSTIN JOSEPH FAZIO (M.D.)?
Travel planning: use Milwaukee, Wisconsin as the reference point for MR. JUSTIN JOSEPH FAZIO (M.D.), then confirm.
Does MR. JUSTIN JOSEPH FAZIO (M.D.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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