Individual provider Active NPI

Samuel G Marcotullio, DO

  • Internal Medicine Physician
  • Pittsburgh, PA
National Provider Identifier
1285633222
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS013369 Issued in PA
Practice address
30 High St
Pittsburgh, PA 15223-1954
Phone
(412) 482-6800
Fax
(412) 781-2123
NPI assigned
Jul 20, 2005
Last updated
May 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X OS013369 PA
Internal Medicine Physician 207R00000X OS013369 PA Primary

Addresses

Primary practice location

30 High St
Pittsburgh, PA 15223-1954

Mailing address

30 High St
Pittsburgh, PA 15223-1954
Phone (412) 482-6800

Other practice location 1

2570 Haymaker Rd
Monroeville, PA 15146
Phone (412) 858-7618

Other identifiers 1

IdentifierTypeStateIssuer
101346916MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smarcotullio11118@direct.ahn.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20050829000670 PA Practitioner - Internal Medicine 6103857206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Medical Associates PCGroup PAC ID 9830003235, 104 clinicians

Practice addresses (Care Compare)

2570 Haymaker Rd
Monroeville, PA 15146-3513
Phone (412) 858-7618

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Associates PC Internal Medicine CurrentSince May 18, 2008 Accepting new patients
Vish V.Iyer MD, PC CurrentSince May 1, 2022 Accepting new patients
Premier Medical Associates, PC CurrentSince May 18, 2008 Accepting new patients
McAuley Medical Associates Inc Past Accepting new patients
West Penn Allegheny Health System Inc. Past Accepting new patients

Locations

2570 Haymaker Rd
Monroeville, PA 15146
Phone (412) 858-2000

3824 Northern Pike
Ste 200
Monroeville, PA 15146
Phone (412) 380-2800

3824 Northern Pike
Ste 300
Monroeville, PA 15146
Phone (412) 856-5335

3824 Northern Pike
Ste 700
Monroeville, PA 15146
Phone (412) 457-0060

30 High St
Pittsburgh, PA 15223
Phone (412) 782-6800

Interoperability endpoints

  • Direct secure messaging: smarcotullio@direct.excelahealth.org
  • Direct secure messaging: smarcotullio11118@direct.ahn.org

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

Hospital & facility affiliations 5

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1285633222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HIGH ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152231954",
            "telephone_number": "412-482-6800",
            "fax_number": "412-781-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HIGH ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152231954",
            "telephone_number": "412-482-6800",
            "fax_number": "412-781-2123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2570 Haymaker Rd",
            "address_purpose": "LOCATION",
            "city": "Monroeville",
            "state": "PA",
            "postal_code": "15146",
            "country_code": "US",
            "telephone_number": "412-858-7618",
            "fax_number": "412-858-7628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCOTULLIO",
        "first_name": "SAMUEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "OS013369",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS013369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101346916",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smarcotullio11118@direct.ahn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2570 Haymaker Rd",
            "city": "Monroeville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "15146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.