Individual provider Active NPI

Colton Dean Marucci, M.D.

  • Anesthesiology Physician
  • Birmingham, AL
National Provider Identifier
1407234339
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
S6241 Issued in TX
Practice address
625 19TH St S
Birmingham, AL 35233-1900
Phone
(205) 934-6525
NPI assigned
May 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X S6241 TX Primary

Addresses

Primary practice location

625 19TH St S
Birmingham, AL 35233-1900

Mailing address

625 19TH St S
Birmingham, AL 35233-1900
Phone (205) 934-6525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220504000475 TX Practitioner - Anesthesiology 9133430499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Texas Southwestern Medical School at Dallas, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Texas Cardiovascular AnesthesiaGroup PAC ID 1951839414, 12 clinicians

Practice addresses (Care Compare)

12446 W Ave
Suite 200
San Antonio, TX 78216-2530
Phone (210) 525-1668

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S6241TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Cardiovascular Anesthesia Anesthesiology CurrentSince Dec 9, 2024 Accepting new patients

Locations

12446 West Ave
Ste 200
San Antonio, TX 78216
Phone (210) 690-0230

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

Organizations & group practices 1

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 3

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": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1407234339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900",
            "telephone_number": "205-934-6525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900",
            "telephone_number": "205-934-6525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARUCCI",
        "first_name": "COLTON",
        "middle_name": "DEAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-12",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "S6241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.