Active NPI
Michael Geno Marcaccini, PHARMD
- Pharmacist
- Eveleth, MN
National Provider Identifier
1093190191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 122467
- Practice address
- 318 Grant Ave
Eveleth, MN 55734-1524 - Phone
- (218) 744-2774
- Fax
- (218) 744-5878
- NPI assigned
- Jul 30, 2015
- Last updated
- Jul 30, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 122467 | MN | Primary |
Addresses
Primary practice location
318 Grant Ave
Eveleth, MN 55734-1524
Mailing address
318 Grant Ave
Eveleth, MN 55734-1524
Phone (218) 744-2774
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 122467 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jons Drug Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438214400000",
"number": "1093190191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "318 GRANT AVE",
"city": "EVELETH",
"state": "MN",
"postal_code": "557341524",
"telephone_number": "218-744-2774",
"fax_number": "218-744-5878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "318 GRANT AVE",
"city": "EVELETH",
"state": "MN",
"postal_code": "557341524",
"telephone_number": "218-744-2774",
"fax_number": "218-744-5878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCACCINI",
"first_name": "MICHAEL",
"middle_name": "GENO",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-30",
"last_updated": "2015-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "122467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eveleth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.