Kevin a Fuciarelli MD PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

29740 Issued in AZ

Legal business name

KEVIN A FUCIARELLI MD PC

Practice address

10615 N Hayden Rd
Suite C 100-102
Scottsdale, AZ 85260-5734

Phone

(480) 513-7047

NPI assigned

Dec 16, 2006

Last updated

Oct 21, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kevin A Fuciarelli, MDNPI 1689859514

Title

President

Phone

(480) 513-7047

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin Fuciarelli, M.D.

  • Specialist
  • Scottsdale, AZ
  • NPI 1689859514
  Medicare reassignment NPD Authorized official
• Martin S Chattman, M.D.

  • Family Medicine Physician
  • Carefree, AZ
  • NPI 1427117894
  NPD (past)
• William Michael Marsh, M.D.

  • General Practice Physician
  • Cave Creek, AZ
  • NPI 1659385441
  NPD (past)

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

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1023170750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23823 N 113TH PL",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852555637",
            "telephone_number": "480-513-7047",
            "fax_number": "480-948-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10615 N HAYDEN RD",
            "address_2": "SUITE C 100-102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852605734",
            "telephone_number": "480-513-7047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN A FUCIARELLI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-16",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "FUCIARELLI",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-513-7047",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "29740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond H Ketcham, FNP
• Kathleen Ketelson, FNP
• Liliana Kettenburg
• Ketteys Exchange for Children and Women Resources
• Kathleen Beverly Keung
• Kevin Concannon LLC (E. M. Diagnostics)
• Kevin Forey MD, PLLC
• Kevin M. Harris DDS, PLLC
• Key Physical Therapy, LLC
• Amanda Key, DNP

• Dermatology Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.