Active NPI
Gerald Anthony Maccioli, MD
- Anesthesiology Physician
- Raleigh, NC
National Provider Identifier
1104937085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 29769
- Practice address
- 3400 Wake Forest Rd
Raleigh, NC 27609-7317 - Phone
- (919) 954-3765
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 29769 | NC | Primary |
| Critical Care Medicine (Anesthesiology) Physician | 207LC0200X | 29769 | NC |
Addresses
Primary practice location
3400 Wake Forest Rd
Raleigh, NC 27609-7317
Mailing address
3100 Spring Forest Rd
Suite 130
Raleigh, NC 27616-2880
Phone (919) 873-9533
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89132EW | Medicaid | NC | |
| 050011528 | Other | NC | RAILROAD-MEDICARE |
| 132EW | Other | NC | BCBS NC |
| 57292 | Other | NC | MEDCOST |
| 6715051 | Other | NC | CIGNA |
| 24432 | Other | NC | PARTNERS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29769 | NC | MD | Critical Care Medicine (Anesthesiology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428019200000",
"number": "1104937085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 SPRING FOREST RD",
"address_2": "SUITE 130",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276162880",
"telephone_number": "919-873-9533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 WAKE FOREST RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276097317",
"telephone_number": "919-954-3765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACCIOLI",
"first_name": "GERALD",
"middle_name": "ANTHONY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2015-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NC",
"license": "29769",
"primary": true
},
{
"code": "207LC0200X",
"taxonomy_group": "",
"desc": "Anesthesiology, Critical Care Medicine",
"state": "NC",
"license": "29769",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89132EW",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD-MEDICARE",
"identifier": "050011528",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NC",
"identifier": "132EW",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "57292",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "6715051",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS",
"identifier": "24432",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.