NPIMap

Individual provider Active NPI

Lee Fucich, MD

  • Clinical Pathology/Laboratory Medicine Physician
  • Mobile, AL
National Provider Identifier
1033191150
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
20718 Issued in AL
Practice address
5 Mobile Infirmary Cir
Mobile, AL 36607-3513
Phone
(251) 460-0326
Fax
(251) 460-2846
NPI assigned
Nov 15, 2005
Last updated
Jul 22, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 20718 AL Primary

Addresses

Primary practice location

5 Mobile Infirmary Cir
Mobile, AL 36607-3513

Mailing address

PO Box 91498
Mobile, AL 36691-1498
Phone (251) 460-0326

Other identifiers 2

IdentifierTypeStateIssuer
009939717MedicaidAL
009912217MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111019000485 AL Practitioner - Pathology 2365549037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Tulane University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf Regional Pathologists PAGroup PAC ID 9830115385, 8 clinicians

Practice addresses (Care Compare)

5 Mobile Infirmary Cir
Mobile, AL 36607-3513
Phone (251) 435-2400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90 of 100Reported as group
Quality
80
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20718ALMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Infirmary Association Current Accepting new patients
Gulf Regional Pathologists PA CurrentSince Jul 1, 1997 Accepting new patients
Mobile Infirmary Association Current Accepting new patients

Locations

750 Morphy Ave
Fairhope, AL 36532
Phone (251) 928-2375

3280 Dauphin St
Ste C105
Mobile, AL 36606
Phone (251) 471-2688

5 Mobile Infirmary Cir
Mobile, AL 36607
Phone (251) 432-4415

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1033191150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91498",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366911498",
            "telephone_number": "251-460-0326",
            "fax_number": "251-460-2846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MOBILE INFIRMARY CIR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366073513",
            "telephone_number": "251-460-0326",
            "fax_number": "251-460-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUCICH",
        "first_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "AL",
            "license": "20718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009939717",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009912217",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.