MICHAEL CARUSO — NPI 1114583515 (Licensed & Credentialed Contractor in ETNA, OH)

CMS-1500 Box 24J / 33a • NPI

1114583515

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

171W00000X

Licensed & Credentialed Contractor

Box 32 Service Location & ZIP+4

19 BURREED CT, ETNA, OH, 43062-9638

✓ 9-Digit EDI 837 ZIP+4 (43062-9638)

Practice Phone & Referral Fax

(614) 824-8811

Fax: (740) 919-0258

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1114583515 (MICHAEL CARUSO) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1114583515` (NPI-1 Individual Practitioner)
Provider / Legal Name	MICHAEL CARUSO
Plain-English Specialty	Licensed & Credentialed Contractor NUCC Code: `171W00000X` (Contractor)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	19 BURREED CT, ETNA, OH, 43062-9638
Practice Telephone / Fax	Tel: (614) 824-8811 \| Fax: (740) 919-0258
Administrative Mailing Address	PO BOX 1011, PATASKALA, OH, 43062-1011
Enumeration & Last Sync	Enumerated: 2019-05-13 \| CMS Record Updated: 2019-06-11

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

19 BURREED CT, ETNA, OH, 43062-9638

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Plain-English Taxonomy & CMS Crosswalk (171W00000X)

What Does Taxonomy Code 171W00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 171W00000X translates to:
"Licensed & Credentialed Contractor"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Contractor for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (MICHAEL CARUSO)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`171W00000X` — Contractor Plain English: Licensed & Credentialed Contractor	State: OH \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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MICHAEL CARUSO (NPI #1114583515)