NPIMap

Individual provider Active NPI

Paul Patrick Muccino, D.O.

  • Orthopaedic Surgery Physician
  • York, PA
National Provider Identifier
1114126026
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
OS014388 Issued in PA
Practice address
25 Monument Rd
Suite 290
York, PA 17403-5073
Phone
(717) 812-4090
Fax
(717) 812-4092
NPI assigned
Jul 12, 2007
Last updated
Dec 19, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X OS014388 PA Primary
Orthopaedic Trauma Physician 207XX0801X OS014388 PA

Addresses

Primary practice location

25 Monument Rd
Suite 290
York, PA 17403-5073

Mailing address

1803 Mount Rose Ave
Suite B3
York, PA 17403-3051
Phone (717) 851-1405

Other identifiers 8

IdentifierTypeStateIssuer
1571748OtherPAGATEWAY-WMG
20091810OtherPAAMERIHEALTH MERCY-WMG
279555OtherPAUNISON-WMG
3810012464MedicaidWV
956309OtherMDCAREFIRST MD BCBS-WMG
037915800MedicaidMD
102158456MedicaidPA
2053366OtherPAHIGHMARK BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20080717000734 PA Practitioner - Orthopedic Surgery 6507939907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Lake Erie College of Osteopathic Medicine, Erie, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

1001 S George St
York, PA 17403-3676

1001 S George St 2ND Floor
Wellspan Pulmonary and Sleep Medicine
York, PA 17403-3676
Phone (717) 851-2465

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

25 Monument Rd
York, PA 17403-5073

2618 E Market St
Autumn House
York, PA 17403
Phone (717) 845-7214

914 W Market St
Autumn House West
York, PA 17403
Phone (717) 845-7214

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Sep 1, 2009 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Sep 1, 2009 Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

1600 S George St
York, PA 17403
Phone (717) 848-3615

1803 Mount Rose Ave
Ste B3
York, PA 17403
Phone (717) 851-6816

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

25 Monument Rd
Ste 290
York, PA 17403
Phone (717) 741-8220

Interoperability endpoints

  • Direct secure messaging: pmuccino13905@wellspan.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1114126026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 MOUNT ROSE AVE",
            "address_2": "SUITE B3",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033051",
            "telephone_number": "717-851-1405",
            "fax_number": "717-812-4092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MONUMENT RD",
            "address_2": "SUITE 290",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174035073",
            "telephone_number": "717-812-4090",
            "fax_number": "717-812-4092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCCINO",
        "first_name": "PAUL",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "OS014388",
            "primary": true
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "PA",
            "license": "OS014388",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY-WMG",
            "identifier": "1571748",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY-WMG",
            "identifier": "20091810",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON-WMG",
            "identifier": "279555",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810012464",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD BCBS-WMG",
            "identifier": "956309",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037915800",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102158456",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "2053366",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.