Individual provider Active NPI

Andrea Dawn Mucci, MD

  • Pediatric Endocrinology Physician
  • Cleveland, OH
National Provider Identifier
1093121980
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
35.124528 Issued in OH
Practice address
9500 Euclid Ave # R3
Cleveland, OH 44195-1716
Phone
(216) 444-7987
Fax
(216) 636-6761
NPI assigned
Jul 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 35.124528 OH Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 35.124528 OH
Pediatric Endocrinology Physician 2080P0205X 57-024002 OH

Addresses

Primary practice location

9500 Euclid Ave # R3
Cleveland, OH 44195-1716

Mailing address

9500 Euclid Ave # R3
Cleveland, OH 44195-0001
Phone (216) 444-7987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171004001825 OH Practitioner - Pediatric MedicinePractitioner - Endocrinology 6204101009 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57-024002OHMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation Multi-Specialty CurrentSince Aug 19, 2017 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

9500 Euclid Ave
#R3
Cleveland, OH 44195

9500 Euclid Ave
#A120
Cleveland, OH 44195
Phone (216) 444-7556

5172 Leavitt Rd
Lorain, OH 44053
Phone (440) 282-7420

19800 Detroit Rd
Rocky River, OH 44116
Phone (440) 333-1107

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1093121980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE # R3",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-7987",
            "fax_number": "216-636-6761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE # R3",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441951716",
            "telephone_number": "216-444-7987",
            "fax_number": "216-636-6761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCCI",
        "first_name": "ANDREA",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-11",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "OH",
            "license": "35.124528",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.124528",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "OH",
            "license": "57-024002",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.