Individual provider Active NPI

Vianca J Masucci, MD

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1245813781
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0103041 Issued in MD
Practice address
1040 Park Ave Ste 200
Baltimore, MD 21201-5634
Phone
(443) 738-0300
Fax
(443) 738-0301
NPI assigned
May 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0103041 MD
Internal Medicine Physician 207R00000X D0103041 MD Primary

Addresses

Primary practice location

1040 Park Ave Ste 200
Baltimore, MD 21201-5634

Mailing address

3005 Rueckert Ave
Baltimore, MD 21214-2916
Phone (973) 866-8286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250811003037 MD Practitioner - Internal Medicine 2567861925 Reassigns benefits to 1 organization
I20250813000895 TX Practitioner - Pediatric Medicine 2567861925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Pennsylvania State University College of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 600
Tuba City, AZ 86045

PO Box
Suite 600
Tuba City, AZ 86045-0600

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tuba City Regional Health Care Corporation Internal Medicine Current Accepting new patients
Baltimore Medical System, Inc. CurrentSince Aug 1, 2025 Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Aug 4, 2025 Accepting new patients
Baltimore Medical System, Inc. CurrentSince Aug 1, 2025 Accepting new patients
Tuba City Regional Health Care Corporation Internal Medicine CurrentSince Aug 4, 2025 Accepting new patients

Locations

1040 Park Ave
Ste 200
Baltimore, MD 21201
Phone (443) 738-0300

1000 Stewart Ave
Glen Burnie, MD 21061

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1245813781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 RUECKERT AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212142916",
            "telephone_number": "973-866-8286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 PARK AVE STE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015634",
            "telephone_number": "443-738-0300",
            "fax_number": "443-738-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASUCCI",
        "first_name": "VIANCA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0103041",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0103041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.