NPIMap

Individual provider Active NPI

Shane Colin Ciucci, PA-C

  • Physician Assistant
  • Charleston, WV
National Provider Identifier
1215610191
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
501 Morris Street
Charleston, WV 25301
Phone
(304) 388-5432
NPI assigned
Aug 8, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

501 Morris Street
Charleston, WV 25301

Mailing address

400 Association Drive
Suite 102
Charleston, WV 25311
Phone (304) 760-7536

Other practice location 1

1540 Spring Valley Dr
Huntington, WV 25704-9501
Phone (304) 691-1700

Other practice location 2

3200 MacCorkle Avenue, SE
Charleston, WV 25304
Phone (304) 388-5432

Other practice location 3

1400 Hospital Drive
Hurricane, WV 25526
Phone (304) 757-1700

Other practice location 4

800 Pennsylvania Avenue
Charleston, WV 25302
Phone (304) 388-5432

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shane.ciucci@vandaliahealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20251219002853 WV Practitioner - Physician Assistant 6103311832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-7823

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
964WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince Aug 21, 2025 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Aug 21, 2025 Accepting new patients

Locations

800 Pennsylvania Ave
Charleston, WV 25302
Phone (304) 388-2550

400 Association Dr
Ste 102
Charleston, WV 25311
Phone (304) 388-1762

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

1400 Hospital Dr
Hurricane, WV 25526
Phone (304) 757-1700

Organizations & group practices 2

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 11

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": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1215610191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ASSOCIATION DRIVE",
            "address_2": "SUITE 102",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25311",
            "telephone_number": "304-760-7536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MORRIS STREET",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25301",
            "telephone_number": "304-388-5432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1540 Spring Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257049501",
            "country_code": "US",
            "telephone_number": "304-691-1700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 MacCorkle Avenue, SE",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "25304",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Hospital Drive",
            "address_purpose": "LOCATION",
            "city": "Hurricane",
            "state": "WV",
            "postal_code": "25526",
            "country_code": "US",
            "telephone_number": "304-757-1700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Pennsylvania Avenue",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "25302",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CIUCCI",
        "first_name": "SHANE",
        "middle_name": "COLIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-08",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shane.ciucci@vandaliahealth.org",
            "affiliation": "N",
            "address_1": "501 Morris Street",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "25301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.