Marianna Grace Bettina Pucillo, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95013728 Issued in CA

Practice address

10121 Pine Ave
Truckee, CA 96161-4835

Phone

(530) 550-7206

NPI assigned

Jan 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tahoe Forest Hospital DistrictGroup PAC ID 0446161335, 140 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tahoe Forest Hospital Hospital, Truckee, CA, CCN 051328
• Incline Village Community Hospital Hospital, Incline Village, NV, CCN 291301
• Eastern Plumas Hospital - Portola Campus Hospital, Portola, CA, CCN 051300

Merit-based Incentive Payment System (MIPS)

Final score

75.06 of 100Reported as group

Quality

83.97

Promoting interoperability

88

Improvement activities

40

Cost

42.89

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpucillo1029917@directa.mercy.net

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.

• Tahoe Forest Hospital District

  • Multi-Specialty Clinic/Center
  • Truckee, CA
  • NPI 1750412300
  Medicare reassignment Care Compare group NPD
• Tahoe Forest Hospital District

  • Multi-Specialty Clinic/Center
  • Truckee, CA
  • NPI 1538689583
  NPD
• Tahoe Forest Hospital District

  • Rural Health Clinic/Center
  • Truckee, CA
  • NPI 1760038772
  NPD
• Tahoe Forest Hospital District

  • Critical Access Hospital
  • Truckee, CA
  • NPI 1538265780
  NPD (past)

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

• Eastern Plumas Health Care District

  • Critical Access Hospital
  • Portola, CA
  • NPI 1326044140
  Care Compare affiliation
• Eastern Plumas Health Care District

  • Critical Access Hospital
  • Portola, CA
  • NPI 1982600920
  Care Compare affiliation
• Tahoe Forest Hospital District

  • Critical Access Hospital
  • Truckee, CA
  • NPI 1538265780
  Care Compare affiliation
• Tahoe Forest Hospital District

  • Critical Access Hospital
  • Incline Village, NV
  • NPI 1801957667
  Care Compare affiliation

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1124658067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77",
            "city": "TAHOE CITY",
            "state": "CA",
            "postal_code": "961450077",
            "telephone_number": "781-454-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10121 PINE AVE",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614835",
            "telephone_number": "530-550-7206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCILLO",
        "first_name": "MARIANNA",
        "middle_name": "GRACE BETTINA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-20",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95013728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Soraya Pourtabib, MD
• Lisa Marie Powell, MA, LMFT
• Katelyn Price
• Tonique Price
• Gail A Prichard, M.D.
• Mileydi Ramirez, MSW, ACSW
• Phillip K Ravinale, DC
• Sarah Louise Yeo Redgrave, LCSW
• Alaina Shapiro Reichwald, LMFT
• Donald Reid

• Nurse Practitioner in Truckee, CA
• Providers in Truckee, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.