Individual provider Active NPI

Heather Anne Cucchetti, D.O.

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1265571665
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
005713 Issued in AZ
Practice address
4400 N 32ND St Ste 110
Phoenix, AZ 85018-3961
Phone
(602) 956-9595
Fax
(602) 956-3232
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 005713 AZ Primary

Addresses

Primary practice location

4400 N 32ND St Ste 110
Phoenix, AZ 85018-3961

Mailing address

4400 N 32ND St Ste 110
Phoenix, AZ 85018-3961
Phone (602) 956-9595

Other identifiers 3

IdentifierTypeStateIssuer
754844MedicaidAZ
Z156811OtherAZMEDICARE PIN- PIMA COUNTY
Z156810OtherAZMEDICARE UPIN- PINAL COUNTY

Other names 1

  • Dr. Heather Anne Ingram Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130401000456 AZ Practitioner - Family Practice 9234118373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunny View Medical Center PLLCGroup PAC ID 7810952686, 4 clinicians

Practice addresses (Care Compare)

4400 N 32ND St
Suite 110
Phoenix, AZ 85018-3964
Phone (602) 956-9595

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005713AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunny View Medical Center PLLC Family Medicine Current Accepting new patients
Sunny View Medical Center, PLLC CurrentSince Aug 1, 2018 Accepting new patients

Locations

4400 N 32nd St
Ste 110
Phoenix, AZ 85018
Phone (602) 956-9595

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 2

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1265571665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 N 32ND ST STE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850183961",
            "telephone_number": "602-956-9595",
            "fax_number": "602-956-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 N 32ND ST STE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850183961",
            "telephone_number": "602-956-9595",
            "fax_number": "602-956-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUCCHETTI",
        "first_name": "HEATHER",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "005713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "754844",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN- PIMA COUNTY",
            "identifier": "Z156811",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE UPIN- PINAL COUNTY",
            "identifier": "Z156810",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "INGRAM",
            "middle_name": "ANNE",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.