Kevin Cuccaro, DO

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

DO154079 Issued in OR

Practice address

3680 NW Samaritan Dr
Corvallis, OR 97330-3737

Phone

(541) 754-1150

NPI assigned

Apr 2, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Aug 2, 2015 through Aug 2, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315699200000",
    "number": "1003937772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 NW ELKS DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303745",
            "telephone_number": "541-754-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 NW SAMARITAN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303737",
            "telephone_number": "541-754-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUCCARO",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2011-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OR",
            "license": "DO154079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tashia Monique Crump, EFDA
• Kelley C Crusius, FNP-C
• Veronica Cruzen
• Robert Frank Csintalan, DPT
• CSL - Corvallis, LLC
• Lisa A Cuevas
• Kristi Anne Culley
• Charmagne Marie Cummings, BACHELORS
• Patrick W Cummings
• Rebecca A. Cummings

• Pain Medicine (Anesthesiology) Physician in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Pain Medicine (Anesthesiology) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.