NPIMap

Individual provider Active NPI

Chad Joseph Micucci, M.D.

  • Orthopaedic Surgery Physician
  • Morgantown, WV
National Provider Identifier
1386899664
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
24024 Issued in WV
Practice address
200 Orthopedic Way
Morgantown, WV 26505-1240
Phone
(304) 599-0720
Fax
(304) 599-3962
NPI assigned
Nov 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 24024 WV Primary

Addresses

Primary practice location

200 Orthopedic Way
Morgantown, WV 26505-1240

Mailing address

200 Orthopedic Way
Morgantown, WV 26505-1240
Phone (304) 599-0720

Other identifiers 1

IdentifierTypeStateIssuer
3810018320MedicaidWV

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
I20100831000074 WV Practitioner - Orthopedic Surgery 8628120557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
West Virginia University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountainstate Orthopedic Associates IncGroup PAC ID 5991744203, 9 clinicians
Rehab-Bray LLCGroup PAC ID 8527256460, 84 clinicians

Practice addresses (Care Compare)

200 Orthopedic Way
Morgantown, WV 26505-1240
Phone (304) 599-0720

2716 Sunset Blvd
Steubenville, OH 43952-1155
Phone (740) 264-0772

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
25.2 of 100Reported as individual
Quality
5.94
Improvement activities
0
Cost
76.08

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement25
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24024WVMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mountainstate Orthopedic Associates, Inc. Orthopaedic Surgery CurrentSince Aug 30, 2010 Accepting new patients
Tuckahoe Orthopaedic Associates, LTD Orthopaedic Surgery PastSince Dec 18, 2022 Accepting new patients

Locations

200 Orthopedic Way
Morgantown, WV 26505
Phone (304) 599-0720

Organizations & group practices 3

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 10

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": "1228003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1386899664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ORTHOPEDIC WAY",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265051240",
            "telephone_number": "304-599-0720",
            "fax_number": "304-599-3962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ORTHOPEDIC WAY",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265051240",
            "telephone_number": "304-599-0720",
            "fax_number": "304-599-3962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICUCCI",
        "first_name": "CHAD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-30",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WV",
            "license": "24024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810018320",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.