Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lara Michaela Jude Fusco, PA-C

Individual provider Physician Assistant · NPI 1518665553

Lara Michaela Jude Fusco, PA-C is a Physician Assistant in Port Jefferson Station, New York. Graduated from Yale University School of Medicine in 2022, 4 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
4
Trained at
Yale University School of Medicine
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

815 Hallock Ave Ste A
Port Jefferson Station, NY 11776-1244
Phone: (631) 828-3036
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1518665553
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 20, 2023
Last updated in NPPESAugust 18, 2025
Certification dateAugust 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolYALE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2022 (4 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

Other providers in Port Jefferson Station