Individual provider Active NPI

Michael J Fucci, DO

  • Cardiovascular Disease Physician
  • Norwich, CT
National Provider Identifier
1104896224
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
042445 Issued in CT
Practice address
79 Wawecus St
Suite #106
Norwich, CT 06360-2160
Phone
(860) 886-2679
Fax
(860) 889-2862
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 042445 CT Primary

Addresses

Primary practice location

79 Wawecus St
Suite #106
Norwich, CT 06360-2160

Mailing address

79 Wawecus St
Suite #106
Norwich, CT 06360-2160
Phone (860) 886-2679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20050729000606 CT Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7618905761 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of New England, College of Osteo Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

200 Sandy Hollow Rd
Mystic, CT 06355-1744
Phone (860) 572-2344

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042445CTMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Cardiovascular Disease CurrentSince May 27, 2020 Accepting new patients
Yale University CurrentSince Nov 29, 2012 Accepting new patients
Yale University CurrentSince Nov 29, 2012 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince May 27, 2020 Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

200 Sandy Hollow Rd
Mystic, CT 06355
Phone (860) 536-4916

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

111 Salem Tpke
Ste 8
Norwich, CT 06360
Phone (860) 886-0023

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

79 Wawecus St
Ste 106
Norwich, CT 06360
Phone (860) 886-2679

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

Organizations & group practices 4

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.

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1104896224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 WAWECUS ST",
            "address_2": "SUITE #106",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602160",
            "telephone_number": "860-886-2679",
            "fax_number": "860-889-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 WAWECUS ST",
            "address_2": "SUITE #106",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602160",
            "telephone_number": "860-886-2679",
            "fax_number": "860-889-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUCCI",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "042445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.