Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Maxine Anne Fusaro, PA-C

Individual provider Physician Assistant · NPI 1770348898

Maxine Anne Fusaro, PA-C is a Physician Assistant in Saint Paul, Minnesota. Qualified in 2023, 3 years ago. Practices with Fairview Express Care, a 1,964-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
3
Licensed in
MN
In the registry since
2024
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

640 Jackson St
Saint Paul, MN 55101-2595
Phone: (651) 254-3456
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 14820 (MN)

Record details

NPI number1770348898
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedFebruary 19, 2024
Last updated in NPPESFebruary 19, 2024
Certification dateFebruary 17, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Fairview Express Care — 1964 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations10 on file with Medicare

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